华蟾素对肺癌患者免疫功能及血清肿瘤标志物的影响研究

Effect of Cinobufagin on Immune Function and Serum Tumor Markers in Patients with Lung Cancer

【目的】探讨华蟾素对非小细胞肺癌(NSCLC)患者免疫功能及血清肿瘤标志物的影响。【方法】将79例NSCLC患者随机分为对照组48例和观察组49例。2组患者均给予常规化疗,在此基础上,观察组给予加用华蟾素治疗。1个月为1个疗程,共治疗3个疗程。观察2组患者治疗前后免疫功能指标及血清肿瘤标志物的变化情况,比较2组患者的临床疗效、不良反应及预后情况。【结果】(1)治疗3个月后,观察组的总有效率为77.55%(38/49),对照组为56.25%(27/48),组间比较,观察组的疗效明显优于对照组(P<0.05)。(2)治疗后,观察组患者血清T淋巴细胞亚群CD3^(+)、CD4^(+)及CD8^(+)水平均较治疗前升高(P<0.05),而对照组患者均无明显变化(P>0.05);组间比较,观察组对血清T淋巴细胞亚群CD3^(+)、CD4^(+)及CD8^(+)水平的升高作用均明显优于对照组(P<0.05或P<0.01)。(3)治疗后,2组患者血清神经元特异性烯醇化酶(NSE)、基质金属蛋白酶9(MMP-9)水平均较治疗前明显降低(P<0.05),且观察组对血清NSE、MMP-9水平的降低作用均明显优于对照组(P<0.01)。(4)治疗过程中,患者的不良反应均以Ⅰ~Ⅱ级为主,其中,2组患者的恶心、血小板减少、肝功能异常、肾功能异常发生率比较,差异均无统计学意义(P>0.05);而2组患者的白细胞减少发生率比较,观察组[12.24%(6/49)]明显低于对照组[29.17%(14/48)],差异有统计学意义(P<0.05)。(5)随访24个月,观察组的2年生存例数为25例,占52.08%;对照组的2年生存例数为19例,占38.78%,组间比较,差异无统计学意义(P>0.05)。【结论】华蟾素能够提高NSCLC患者临床疗效,改善患者免疫功能,降低血清肿瘤标志物水平,减少不良反应发生率,改善患者预后。

Objective To investigate the effects of cinobufagin on immune function and serum tumor markers in patients with non-small cell lung cancer(NSCLC).Methods A total of 97 patients with NSCLC were randomly divided into control group(48 patients)and observation group(49 patients).Both groups were treated with conventional chemotherapy,and additionally,the observation group was given cinobufagin orally.One month constituted a course of treatment,and the treatment for the two groups lasted for 3 courses.The changes of immune function index and serum tumor markers in the two gorups before and after treatment were observed,and the clinical efficacy,adverse reactions and prognosis of the two groups of patients were also compared.Results(1)After 3 months of treatment,the total effective rate of the observation group was 77.55%(38/49)and that of the control group was 56.25%(27/48).The intergroup comparison showed that the efficacy of the observation group was significantly superior to that of the control group(P<0.05).(2)After treatment,the levels of serum T lymphocyte subsets CD3^(+),CD4^(+)and CD8^(+)in the observation group were increased compared with those before treatment(P<0.05),while no significant changes were shown in the control group(P>0.05).The intergroup comparison showed the effect on increasing the serum levels of T lymphocyte subsets in the observation group was significantly superior to that in the control group(P<0.05 or P<0.01).(3)After treatment,serum neuron-specific enolase(NSE)and matrix metalloproteinase 9(MMP-9)levels were significantly decreased in both groups compared with those before treatment(P<0.05),and the effect on lowering the serum NSE and MMP-9 levels in the observation group was significantly superior to that in the control group(P<0.01).(4)During the treatment,the adverse reactions of the patients were mainly classified into gradeⅠ-Ⅱ.There were no statistically significant differences shown in the incidence of nausea,thrombocytopenia,abnormal liver function and abnormal kidney function between the two groups(P>0.05).However,the incidence of leukopenia in the observation group[12.24%(6/49)]was significantly lower than that in the control group[29.17%(14/48)],and the difference was statistically significant(P<0.05).(5)The 24-month follow-up showed that there were 25 cases of 2-year survival in the observation group,accounting for 52.08%,and there were 19 cases of 2-year survival in the control group,accounting for 38.78%.The intergroup comparison showed that the difference was not statistically significant between the two groups(P>0.05).Conclusion Cinobufagin has certain effects on enhancing the clinical efficacy of NSCLC patients by improving the immune function,reducing the level of serum tumor markers and the incidence of adverse reactions,and improving the prognosis of NSCLC patients.