| 毛雨秋,庞雯雯.胸腺肽联合化疗治疗老年胃癌患者的临床疗效及对免疫功能、血清MMP-2、MMP-9水平的影响[J].肿瘤学杂志,2018,24(6):587-591. |
| 胸腺肽联合化疗治疗老年胃癌患者的临床疗效及对免疫功能、血清MMP-2、MMP-9水平的影响 |
| Clinical Effect of Thymopeptides Combined with Chemotherapy and the Influence on Immunity and Serum MMP-2 and MMP-9 Levels in the Treatment of Elderly Gastric Cancer Patients |
| 投稿时间：2017-02-06 |
| DOI：10.11735/j.issn.1671-170X.2018.06.B011 |
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| 中文关键词: 胃肿瘤 老年 化疗 胸腺肽 免疫功能 金属基质蛋白酶 |
| 英文关键词:gastric cancer elderly chemotherapy thymopeptides immunity metal matrix protease |
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| 中文摘要: |
| 摘 要：［目的］ 探讨胸腺肽联合化疗治疗老年胃癌患者的临床疗效及对免疫功能、血清MMP-2、MMP-9水平的影响。［方法］ 选取收治的老年胃癌患者98例，随机分为对照组（n=49）及观察组（n=49），对照组患者给予FOLFOX4常规化疗方案治疗，观察组在对照组的基础上联合胸腺肽α1治疗，3周为1个疗程，2组均连续治疗3个疗程。分析2组临床疗效，检测并比较化疗前及化疗3个疗程后2组患者血清T淋巴细胞亚群及NK细胞比例及Th1、Th2细胞因子水平，评价2组免疫功能；另检测并比较治疗前后2组血清金属基质蛋白酶（MMP-2及MMP-9）水平的变化。［结果］ 观察组缓解率为79.59%，显著高于对照组的51.02%（P<0.01）。化疗3个疗程后2组CD4+、CD8+比例及NK细胞比例均较化疗前显著降低，但观察组CD4+比例及NK细胞比例均较对照组显著升高，CD8+比例较对照组显著降低（P均<0.05）；化疗前后对照组CD4+/CD8+比值无明显变化，而观察组化疗后CD4+/CD8+比值明显增加，且显著高于对照组（P<0.01）；与化疗前比较，化疗3个疗程后观察组血清IFN-γ及TNF-α水平明显升高（P<0.01），2组血清IL-4、IL-10水平及MMP-2、MMP-9水平均明显降低（P均<0.05），且2组间差异显著（P<0.05）。观察组不良反应发生率为20.41%（10/49），低于对照组的40.82%（20/49）（P<0.05）。［结论］ 胸腺肽α1可显著提高化疗对老年胃癌的临床疗效，明显调节机体免疫细胞及细胞因子水平，减轻化疗所致的免疫损伤，并可显著降低血清MMP-2及MMP-9水平，降低化疗毒副作用。 |
| 英文摘要: |
| Abstract：［Objective］ To explore the effect of thymopeptides combined with chemotherapy and the influence on immunity and serum MMP-2 and MMP-9 levels in the treatment of elderly gastric cancer patients. ［Methods］ A total of 98 cases elderly gastric cancer patients were elected and divided into control group(n=49) and observation group(n=49). Control group were treated with conventional chemotherapy FOLFOX4，while observation group were treated combined with thymopeptides alpha1 based on the control group，3 weeks were 1 course，2 groups were treated continuously for 3 courses. The clinical efficacy of 2 groups was analyzed，the proportion of T-lymphocyte subsets and NK cells and the cytokine levels of Th1 and Th2 weredetected and compared，the immunity of 2 groups before and after 3 course of chemotherapy were evaluated. Besides，the changes of serum MMP-2 and MMP-9 levels were detected and compared. ［Results］ The RR of observation group was 79.59%，which was higher than that 51.02% of control group(P<0.01)；The proportion of CD4+、CD8+ and NK cells decreased significantly in 2 groups after chemotherapy compared with before chemotherapy，while the proportion of CD4+ and NK cells increased significantly and the proportion of CD8+ decreased significantly compared with control group after 3 course of chemotherapy(all P<0.05)，the CD4+/CD8+ of control group had no significant changes，while the CD4+/CD8+ of observation group increased significantly and which were higher than that of control group after 3 course of chemotherapy(P<0.01). Compared with before chemotherapy，the levels of IFN-γ and TNF-α increased significantly after 3 course of chemotherapy(P<0.01)，the levels of serum IL-4，IL-10 and MMP-2，MMP-9 decreased significantly(all P<0.05)，and there were significant difference between 2 groups(P<0.05 or P<0.01)；The incidence of adverse reactions of observation group was 20.41%(10/49)，which was lower than that 40.82%(20/49) of control group(P<0.05). ［Conclusion］ Thymopeptides can raise the clinical efficacy of chemotherapy in the treatment of elderly gastric cancer significantly，and which can adjust the immune cells and cytokines levels，reduce the immune injury caused by chemotherapy and reduce the levels of serum MMP-2，MMP-9，reduce the side effects of chemotherapy. |
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