摘要
目的探讨乙酰半胱氨酸泡腾片预防非小细胞肺癌放射性肺炎的临床价值。方法将非小细胞肺癌患者68例根据入院先后随机分为2组各34例,应用调强放疗的患者为对照组,在放疗的同时口服乙酰半胱氨酸泡腾片的患者为观察组。观察2组治疗前后肺功能第1秒用力呼气容积(forced expiratory volume in first second,FEV_1)、用力肺活量(forced vital capacity,FVC),血清指标白细胞介素6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α),治疗后放射性肺炎发生率和骨髓抑制情况。结果对照组治疗后FEV_1和FVC水平明显低于治疗前(P<0.05),观察组治疗后与治疗前变化不大,观察组治疗后FEV_1和FVC水平高于对照组,差异有统计学意义(P<0.05);治疗后2组IL-6和TNF-α水平均较治疗前升高,但观察组升高幅度小,治疗后观察组IL-6和TNF-α水平明显低于对照组,差异有统计学意义(P<0.05)。观察组3~5级放射性肺炎发生率为14.7%,明显低于对照组的35.3%(P<0.05);骨髓抑制发生率为50.0%,明显低于对照组的79.4%(P<0.05)。结论非小细胞肺癌患者应用乙酰半胱氨酸泡腾片可缓解炎症反应,改善肺通气功能,减少放射性肺炎和骨髓抑制,值得在临床上推广应用。
Objective To explore the clinical values of acetylcysteine effervescent tablets in prevention of radiation pneumonitis for patients with non-small cell lung cancer（NSCLC）.Methods A total of 68 consecutives as NSCLC were enrolled and divided randomly into control and observation groups, each with 34 cases, Control group was received intensity-modulated radiation, observation group was adopted oral acetylcysteine effervescent tablets. The differences of lung function forced expiratory volume in first second （FEV 1）, forced vital capacity（FVC）, serum interleukin-6（IL-6）, tumor necrosis factor-α（TNF-α） levels and the rates of radiation pneumonia and bone marrow suppression were compared.Results The values of FEV 1 and FVC in control group after treatment were lower than before treatment（ P 〈 0.05）,while there were no statistical difference in observation group（ P 〉 0.05）. The values of FEV 1 and FVC in observation group were significantly higher than in control group after treatmen（ P 〈 0.05）. The levels of IL-6 and TNF-α in the two groups were higher than that before treatment（ P 〈 0.05）, but observation group were still significantly lower than control group after treatmen（ P 〈 0.05）.The incidences of 3~5 level radioactive pneumonia and bone marrow suppression in observation group were both significantly less than that in control group（ 14.7% vs 35.3% , 50.0% vs 79.4% , P 〈 0.05）.Conclusion It can greatly alleviate inflammation, improve pulmonary ventilation function,reduce the radioactive pneumonia and bone marrow suppression rates in patients with NSCLC by acetylcysteine effervescent tablets.
作者
卢秀荣
宋晓
邹念东
张贤雨
原娜
张志林
LU Xiu-rong;SONG Xiao;ZOU Nian-dong;ZHANG Xian-yu;YUAN Na;ZHANG Zhi-lin(Department of Radiation Oncology,the First Hospital Affiliated with Northern Hebei University,Zhangjiakou 075000,Chin)
出处
《河北医科大学学报》
CAS
2018年第9期1049-1052,共4页
Journal of Hebei Medical University
基金
张家口市科学技术研究与发展计划(1421151D)
关键词
癌
非小细胞肺
辐射性肺炎
乙酰半胱氨酸
carcinoma
non-small-cell lung
radiation pneumonitis
acetylcysteine
