益生菌在妇瘤患者急性放射性肠炎发生中的预防价值

The preventive effect of probiotics on acute radiation enteritis in gynecological tumor patients

目的:探讨在盆腔放疗中益生菌对急性放射性肠炎(ARE)的预防作用。方法:收集行盆腔放疗的妇瘤患者96例,随机分为观察组48例和对照组48例,观察组在放疗第1天开始服用益生菌(双歧杆菌三联活菌胶囊)直至放疗结束,对照组不预防应用益生菌,比较两组放疗期间ARE发生率的差异;放疗结束时进行炎症性肠病生活质量(IBDQ)评分;所有患者均在放疗前1天和放疗15次时分别留取血清进行检测,通过ELISA方法检测肿瘤坏死因子α(TNFα)及白介素8(IL-8)的表达水平;通过Logistic回归分析,明确发生ARE的影响因素。结果:观察组ARE的发生率低于对照组(52.1%vs.72.9%,P<0.05);通过IBDQ评分对比,观察组在生活质量方面显著优于对照组,尤其是在肠道症状、全身症状两方面获益明显;发生ARE的患者TNFα及IL-8的表达显著升高;经过Logistic多因素回归分析,影响ARE发生的因素依次为同步化疗、术后状态、应用益生菌、病种及肿瘤分期。结论:预防性应用益生菌可以有效降低ARE的发生率,改善放疗期间患者的生活质量。

Objective:To explore the preventive effect of probiotics on acute radiation enteritis(ARE)in pelvic radiotherapy.Methods:96 cases of gynecological tumor patients undergoing pelvic radiotherapy were collected and randomly divided into observation group(48 cases)and control group(48 cases).The observation group patients took probiotics(bifidobacterium triple viable capsule)during radiotherapy,and the control group did not use probiotics.The incidence of ARE of two groups were compared;The Inflammatory Bowel Disease Questionnaire(IBDQ)was scored at the end of radiotherapy;Patients’serum were collected at the day before radiotherapy and 15 times of radiotherapy,and the contents of TNFαand IL-8 were detected by Elisa.Logistic regression analysis was conducted to identify the influencing factors of ARE.Results:The incidence rate of ARE in the observation group was significantly lower than that in the control group(52.1%vs.72.9%,P<0.05).By comparing the IBDQ scores,the observation group was significantly better than the control group in quality of life,especially in terms of intestinal symptoms and systemic symptoms;The expressions of TNFαand IL-8 in patients of ARE were significantly increased.Logistic analysis showed that the influencing factors of ARE were synchronous chemotherapy,postoperative status,probiotic,disease type,and stage.Conclusion:Probiotics can effectively prevent the occurrence of ARE and improve the quality of life of patients during radiotherapy.