摘要
目的:比较用地塞米松与甲地孕酮治疗晚期肺癌对患者癌因性疲乏(CRF)的影响。方法:选取泰州市第三人民医院收治的103例晚期肺癌患者作为观察对象。按照入院时间的不同将其分为对照组和观察组。对照组50例患者采用地塞米松进行治疗,观察组53例患者采用甲地孕酮进行治疗。比较两组患者Piper疲乏调查量表的评分、厌食评分、免疫功能指标、营养指标、细胞因子的水平及不良反应的发生率。结果:治疗后,两组患者Piper疲乏调查量表中各项指标的评分均低于治疗前,P<0.05。治疗后,两组患者Piper疲乏调查量表中各项指标的评分相比,P>0.05。治疗后,两组患者血清CD3^(+)T细胞、辅助性T细胞(Th细胞)的水平均高于治疗前,血清转化生长因子-β1(TGF-β1)、肿瘤坏死因子-α(TNF-α)的水平均低于治疗前,P<0.05。治疗后,两组患者血清CD3^(+)T细胞、Th细胞、TGF-β1、TNF-α的水平相比,P>0.05。治疗后,两组患者的厌食评分均低于治疗前,血清前白蛋白(PA)、白蛋白(ALB)的水平均高于治疗前,P<0.05。治疗后,两组患者的厌食评分及血清PA、ALB的水平相比,P>0.05。用药期间,观察组患者失眠的发生率低于对照组患者,P<0.05。结论:用地塞米松与甲地孕酮治疗晚期肺癌均能有效改善患者的CRF及免疫功能,缓解其厌食症状,临床疗效无显著差异,但甲地孕酮引起的不良反应更少,治疗的安全性更高。
Objective:To compare the effects of dexamethasone and megestrol on cancer induced fatigue(CRF)in patients with advanced lung cancer.Methods:A total of 103 patients with advanced lung cancer treated in Taizhou Third People's Hospital were selected as observation objects.According to the time of admission,they were divided into control group and observation group.Control group 50 patients were treated with dexamethasone,observation group 53 patients were treated with megestrol.Piper fatigue Inventory score,anorexia score,immune function index,nutritional index,cytokine level and the incidence of adverse reactions were compared between 2 groups.Results:After treatment,the scores of Piper fatigue scale in both groups were lower than before,P<0.05.After treatment,the Piper fatigue scale scores of the two groups were compared(P>0.05).After treatment,the levels of serum CD3^(+)T cells and helper T cells(Th cells)in 2 groups were higher than before treatment,while the levels of TGF-β1 and tumor necrosis factor-α(TNF-α)in 2 groups were lower than before treatment,P<0.05.After treatment,the levels of CD3^(+)T cells,Th cells,TGF-β1 and TNF-αin serum of 2 groups were compared,P>0.05.After treatment,the anorexia score of 2 groups was lower than before treatment,and the levels of serum prealbumin(PA)and albumin(ALB)were higher than before treatment,P<0.05.After treatment,the anorexia score and serum PA and ALB levels of the two groups were compared,P>0.05.During medication,the incidence of insomnia in observation group was lower than that in control group,P<0.05.Conclusion:The treatment of advanced lung cancer with dexamethasone and megestrol can effectively improve the CRF and immune function,relieve the symptoms of anorexia,there is no significant difference in clinical efficacy,but megestrol caused fewer adverse reactions,the safety of treatment is higher.
作者
王琳
徐旭
WANG Lin;XU Xu(Department of Oncology,Taizhou Third People’s Hospital,Taizhou Jiangsu,225321)
关键词
地塞米松
甲地孕酮
晚期肺癌
癌因性疲乏
免疫功能
不良反应
失眠
dexamethasone
Methylprogesterone
Advanced lung cancer
Cancer-related fatigue
Immune function
Adverse reactions
insomnia