胸腺肽a1联合化疗对晚期卵巢癌患者细胞免疫功能的影响

戴明+杨清蓉+钟华成+罗建文+陈旭兰

[摘要] 目的 探讨胸腺肽α1联合化疗对晚期卵巢癌患者细胞免疫功能的影响。方法 方便选取2013年6月—2016年12月在厦门市中医院肿瘤科收治的52例卵巢癌患者随机分为两组，对照组采用紫杉醇+顺铂常规化疗，观察组在对照组治疗基础上加用胸腺肽α1。比较两组疗效、不良反应，化疗前后血清CRP及外周血NK细胞、T淋巴细胞亚群变化。结果 两组总有效率分別为73.1%和65.4%，差异有统计学意义（P>0.05）；但观察组骨髓抑制严重不良反应发生率低于对照组34.6% vs 69.2%，差异有统计学意义（P<0.05）。化疗后两组CRP分别为（18.64±9.23）和（29.71±9.55），均低于化疗前，且观察组低于对照组；而CD3+、CD4+、CD4+/CD8+及NK细胞活性分别为（76.98±4.63）%，（37.45±2.60）%，（1.66±0.10），（16.86±2.40）%，均高于化疗前，且观察组明显高于对照组。结论 胸腺肽α1联合化疗可增强机体细胞免疫功能，减轻化疗不良反应。

[关键词] 胸腺肽；卵巢癌；紫杉醇；顺铂；细胞免疫

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2017）12（c）-0117-03

[Abstract] Objective This paper tries to observe the effect of thymosin α1 combined with chemotherapy on cellular immune function in patients with advanced ovarian cancer. Methods A total of 52 patients with ovarian cancer hospitalized in oncology department in this hospital from June 2013 to December 2016 were convenient selected and randomly divided into two groups. The control group received conventional chemotherapy with paclitaxel plus cisplatin. The observation group was treated with thymosin α1 on the basis of the control group. The effects and adverse reactions of the two groups were compared， and the changes of serum CRP， NK cells and T lymphocyte subsets in peripheral blood before and after chemotherapy were compared. Results The total effective rate was 73.1% and 65.4% in both groups the difference was statistically significant（P>0.05）. However， the incidence of serious adverse reactions in the observation group was lower than that in the control group（34.6% vs 69.2%），the difference with significant difference（P<0.05）. The CRP levels of two groups after chemotherapy were （18.64±9.23） and （29.71±9.55）， respectively， which were lower than those before chemotherapy and lower than those of the control group. The activities of CD3+， CD4+， CD4+/CD8+ and NK cells were （76.98±4.63）% and （37.45±2.60）%， （1.66±0.10）， （16.86±2.40）%， respectively， which were higher than before chemotherapy， and the observation group was significantly higher than the control group. Conclusion Thymosin α1 combined with chemotherapy can enhance the bodys cellular immune function， reduce chemotherapy adverse reactions.

[Key words] Thymosin； Ovarian cancer； Paclitaxel； Cisplatin； Cell immunity

卵巢癌起病隐匿，约75%的患者确诊时病属晚期（Ⅲ-Ⅳ期）。化疗是中晚期卵巢癌综合治疗的重要手段，其抑制或杀灭肿瘤细胞的同时，也导致肝肾功能损害、骨髓抑制等副作用，影响后续治疗。冯勤梅等[1]认为化疗后患者体内的免疫抑制暂时逆转，可能形成一个实施免疫治疗的“最佳窗口期”。围化疗期联合生物免疫调节剂有望改善人体免疫机能，提供持久、有效的抗肿瘤免疫应答。该研究方便选取2013年6月—2016年12月收治的52例旨在探讨胸腺肽α1联合化疗对上皮性卵巢癌（epithelial ovarian cancer）患者总有效率、不良反应发生率及细胞免疫功能的影响，现报道如下。endprint

1 资料与方法

1.1 一般资料

方便选取该院收治的上皮性卵巢癌患者52例作为研究对象。纳入标准：①根据国际妇产科联合会（International Federation of Gynecology and Obstetrics，FIGO）分期标准，均为Ⅲ期（或）Ⅳ期卵巢癌，经病理学检查确诊，排除转移性或其他部位肿瘤；②均……