血清同型半胱氨酸水平与培美曲塞联合铂类药物治疗肺腺癌疗效的关系分析

Analysis of the Relationship between Serum Homocysteine Level and the Efficacy of Pemetrexed Combined with Platinum Drugs in the Treatment of Lung Adenocarcinoma

目的探究肺腺癌患者经培美曲塞联合铂类药物治疗的效果,并分析与血清同型半胱氨酸水平间的关系。方法该次研究时间范围为2017年3月—2020年3月,方便抽选于该院接受治疗确诊患肺腺癌患者108例作为研究目标,根据患者血清同型半胱氨酸水平差异进行分组,对照组患者同型半胱氨酸水平正常,观察组患者同型半胱氨酸水平较高,根据患者病症表现予以单纯培美曲塞或联合铂类药物治疗,分别对比两组化疗效果,评估患者骨髓抑制情况,同时通过回归模型分析影响血清同型半胱氨酸水平的相关因素。结果通过联合治疗,观察组患者疾病缓解率(50.00%)与控制率(90.74%)均明显高于对照组,差异有统计学意义(χ^(2)=3.990、5.170,P<0.05),观察组骨髓抑制2~4级占比率均明显高于对照组,差异有统计学意义(P<0.05)。相关因素分析发现,影响血清同型半胱氨酸的因素主要包括:血小板数量及骨髓抑制情况,而与患者性别、癌变分期无相关性。多因素分析显示叶酸的服用情况与同型半胱氨酸水平存在联系。结论血清同型半胱氨酸水平较高的肺腺癌患者经培美曲塞联合铂类药物治疗效果较好,但会对患者骨髓产生抑制效果,因而可通过补充叶酸等方式辅助治疗,确保患者正常化疗。

Objective To explore the effect of pemetrexed combined with platinum drugs in patients with lung adenocarcinoma,and to analyze the relationship with serum homocysteine levels.Methods The study time range was from March 2017 to March 2020.108 patients diagnosed with lung adenocarcinoma who received treatment in the hospital were convenient selected as the research target,and the patients were grouped according to differences in serum homocysteine levels.The patients in the control group had normal homocysteine levels,and the patients in the observation group had higher homocysteine levels.Pemetrexed alone or combined with platinum drugs was given according to the symptoms of the patients,and compared the chemotherapy effects of the two groups and evaluated bone marrow suppression of patients,and at the same time analyzeed the related factors that affect the serum homocysteine level through regression model.Results Through combined treatment,the disease remission rate(50.00%)and control rate(90.74%)of the observation group were significantly higher than those of the control group,the difference was statistically significant(χ^(2)=3.990,5.170,P<0.05),and the rate of 2-4 bone marrow suppression in the observation group were significantly higher than the control group,the difference was statistically significant(P<0.05).The analysis of related factors found that the factors affecting serum homocysteine mainly included:the number of platelets and bone marrow suppression,but there was no correlation with the patient's gender and cancer stage.Multivariate analysis showed that there was a relationship between folic acid intake and homocysteine levels.Conclusion Patients with lung adenocarcinoma with high serum homocysteine levels are treated with pemetrexed combined with platinum drugs,but they have a suppressive effect on the bone marrow of the patients.Therefore,supplementary folic acid can be used to supplement the treatment to ensure the patients’normal chemotherapy.