心理干预对肺癌放化疗患者抑郁情绪及免疫因子的影响研究

Study of the Effect of Mental Intervention on the Depressive Emotion and Immune Factors in Lung Cancer Patients Undergoing Chemoradiotherapy

目的研究心理干预对肺癌放化疗患者抑郁情绪及免疫因子的影响。方法选取2014年7至2016年6月于成都医学院第一附属医院肿瘤科行放化疗的肺癌患者118例,依据随机数字表法分为试验组(n=59)与对照组(n=59),两组均行放化疗和常规干预,试验组在此基础上给予心理干预。观察两组干预前后焦虑、抑郁评分,血清白细胞介素-2(IL-2)、皮质醇(Cor)、NK细胞及T细胞(T、Th、Ts)等免疫因子水平,可溶性程序死亡受体1(sPD-1)、程序化细胞死亡分子5(PDCD5)蛋白水平。结果干预后,两组SAS评分、SDS评分、Cor、Ts均降低,IL-2、NK细胞、T、Th、sPD-1、PDCD5蛋白均较干预前增加,试验组SAS评分、SDS评分、Cor、Ts低于对照组,IL-2、NK细胞、T、Th、sPD-1、PDCD5蛋白高于对照组(P<0.05)。试验组ORR率(47.46%)、DCR率(79.66%)分别高于对照组ORR率(32.20%)、DCR率(62.71%)(P<0.05)。结论心理干预可缓解肺癌放化疗患者抑郁情绪,纠正免疫失衡,改善免疫因子水平。

Objective To study the effect of mental intervention on the depressive emotion and immune factors in lung cancer patients undergoing chemoradiotherapy. Methods A total of 118 lung cancer patients undergoing chemoradiotherapy in The First Affiliated Hospital of Chengdu Medical College from July of 2014 to June of 2016 were selected and divided into the mental intervention group ( n =59) and control group ( n =59) according to the random number table method. All the patients of both groups undergone the conventional chemoradiotherapy. The patients in the control group were given the routine intervention, while the patients in the mental intervention group were given the mental intervention as well as the routine intervention. The scores of anxiety and depression and the levels of soluble PD-1 (sPD-1), programmed cell death molecule-5 (PDCD5) protein and the immune factors including serum interleukin-2 (IL-2), cortisol (Cor), NK cells and T cells (T, Th, Ts) in the two groups were detected before and after intervention respectively. Results After the intervention, the scores of SAS and SDS and the levels of Cor and Ts decreased and the levels of IL-2, NK cells, T, Th, sPD-1 and PDCD5 protein increased. The scores of SAS and SDS and the levels of Cor and Ts were significantly lower and the levels of IL-2, NK cells, T, Th, sPD-1 and PDCD5 protein were significantly higher in the mental intervention group than in the control group ( P <0.05). The levels of ORR and DCR in the mental intervention group were 47.46% and 79.66% respectively, and they were significantly higher than those in the control group which were 32.20% and 62.71% respectively. Conclusion The mental intervention can alleviate depressive emotion, correct immune imbalance and improve the level of immune factors in lung cancer patients undergoing chemoradiotherapy.