咖啡酸对食管癌放疗后骨髓抑制的防治效果

杜遵民　贾海鹏　杨莉莉　陈洪雷　陈方国

[摘要] 目的 观察咖啡酸片防治食管癌患者放疗所致骨髓抑制的临床效果。 方法 选择2014年6月～2017年10月解放军第八十八医院经病理证实并接受放疗的食管癌患者72例，采用随机数字表法分为咖啡酸（CFA）组和对照组，每组各36例。CFA组从放疗开始口服咖啡酸片300 mg/次，3次/d，至放疗结束，共6周；对照组单纯放疗，不服用任何升血药物，当出现出现骨髓抑制时，再给予重组人粒细胞刺激因子注射液和/或重组人白细胞介素-11注射剂，直至血象正常。观察两组骨髓抑制发生率和白细胞、血红蛋白和血小板水平。 结果 CFA组患者骨髓抑制发生率、Ⅲ度和Ⅳ度骨髓抑制发生率明显低于对照组，差异有统计学意义（P < 0.05）；CFA组患者放疗后1～6周各时间点白细胞和血小板数均明显高于对照组，差异有统计学性意义（P < 0.05）；CFA组患者放疗后2～6周各时间点血红蛋白水平明显高于对照组，差异有统计学性意义（P < 0.05）。 结论 咖啡酸防治食管癌患者放疗所致的骨髓抑制效果显著。

[关键词] 咖啡酸；食管癌；放疗；骨髓抑制

[中图分类号] R735.1 [文献标识码] A [文章编号] 1673-7210（2018）09（b）-0085-05

[Abstract] Objective To investigate the clinical effects of caffeic acid （CFA） on bone marrow suppression induced by radiotherapy in patients with esophageal cancer. Methods From June 2014 to October 2017， in NO.88 Hospital of PLA， 72 patients with esophageal cancer were selected， they were divided into CFA group and control group by random number table， with 36 cases in each group. Patients in CFA group were given oral CFA tablet 300 mg/time， 3 times/d， lasted until the end of radiotherapy， for 6 weeks； patients in control group were given radiotherapy only， once the bone marrow suppression occured， according to the degree of leucopenia or thrombocytopenia， the patients were given recombinant human granulocyte colony stimulating factor and/or recombinant human interleukin-11 injection subcutaneously. The incidence rate of bone marrow suppression， number of white blood cells （WBC） ， hemoglobin （Hb）， platelet （PlT） were observed. Results The incidence rate of bone marrow suppression， incidence rate of Ⅲ and Ⅳ degree bone marrow suppression in the CFA group were significantly lower than the control group， the differences were statistically significant （P < 0.05）. The number of WBC and PlT in the CFA group 1-6 weeks after radiotherapy were significantly higher than the control group， the differences were statistically significant （P < 0.05）. The number of Hb in the CFA group 1-6 weeks after radiotherapy was significantly higher than the control group， the differences were statistically significant （P < 0.05）. Conclusion Caffeic acid can effectively prevent and treat bone marrow suppression induced by radiotherapy in patients with esophageal cancer.

[Key words] Caffeic acid； Esophageal cancer； Radiotherapy； Bone marrow suppression

咖啡酸片的主要成分是咖啡酸（caffeic acid，CFA），CFA化學名称3-（3，4-二羟苯基）-丙烯酸广泛存在于多种可食性植物及中草药中，具有抗氧化、抗炎和止血、升白细胞、升血小板等作用，临床上用于各种原因引起的白细胞减少症、血小板减少症的治疗[1]。本研究组前期研究发现CFA能促进辐射小鼠的造血恢复，对辐射引起的造血系统损伤有防护作用[2]。解放军第八十八医院（以下简称“我院”）血液科、放疗科应用咖啡酸片防治食管癌放疗引起的骨髓抑制取得良好效果，现报道如下：

1 资料与方法

1.1 一般资料

选择2014年6月～2017年10月我院住院的食管癌放疗患者，包括食管癌术后、放弃手术和晚期无手术指征的患者共72例。……