两种不同化疗方案对晚期非小细胞肺癌患者骨髓抑制及免疫力的影响

目的 探讨不同方案化疗对晚期非小细胞肺癌患者骨髓抑制及免疫力的影响.方法 选择晚期非小细胞肺癌患者46例,随机分为NP组（长春瑞滨＋顺铂）23例和DP组（多西紫杉醇＋顺铂）23例,分别于患者化疗前和2个周期化疗结束后监测骨髓抑制及免疫力,并进行分析.结果 NP组和DP组的中位生存期（MST）分别为10.3个月和6.2个月,1年生存率分别为52.17％和30.43％,两组比较差异均有统计学意义（x2值分别为3.987、4.603,P均＜0.05）.化疗后,DP组血小板计数为（108.87±15.63）×109/L,较NP组（128.17±15.3）×109/L]降低幅度明显（=3.819,P＜0.05）.NP组患者化疗前CD3＋、CD4＋、CD8＋、CD4 ＋/CD8＋及NK分别为（61.17±9.13）％、（36.99±7.83）％、（26.94±6.14）％、（1.93±0.21）％、（30.12±8.62）％;化疗后分别为（52.82±8.19）％、（33.22±6.92）％、（23.21±5.64）％、（1.53±0.11）％、（28.07±8.17）％;各指标较化疗前均明显降低（t值分别为2.097、3.217、2.251、3.027、2.717,P均＜0.05）.DP组化疗前CD3＋、CD4＋、CD8＋、CD4 ＋/CD8＋及NK分别为（62.82±9.13）％、（38.82±9.19）％、（27.81±7.97）％、（1.82±0.13）％、（31.82±7.48）％,化疗后分别为（50.76±8.19）％、（28.92±8.13）％、（20.82±8.93）％、（1.36±0.16）％、（29.12±7.31）％,各指标较化疗前均明显降低（t值分别为2.347、2.591、3.785、2.438、2.157,P均＜0.05）;化疗后,两组患者CD4＋、CD8＋、CD4 ＋/CD8＋比较,差异均有统计学意义（t值分别为2.591、3.785、2.438,P均＜0.05）,CD3＋、NK比较差异无统计学意义（t值分别为0.027、0.323,P均＞0.05）.结论 NP方案化疗能够减轻晚期非小细胞肺癌患者因化疗造成的免疫功能降低程度,对化疗造成的免疫功能降低程度优于DP化疗方案;疗效优于DP化疗方案.

Effect of different chemotherapy regimens on bone marrow suppression and immune of patient with advanced non small cell lung cancer

Objective To investigate the different chemotherapy regimens on bone marrow inhibition and immunity of patients with advanced non small cell lung cancer.Methods Forty-six patients with advanced non-small cell lung cancer were randomly divided into NP group （Changchun vinorelbine plus cisplatin,n =23） and DP group（docetaxel,cisplatin,n =23）.The bone marrow suppression and immune function were analyzed before chemotherapy and after 2 cycles chemotherapy.Results The median survival time（MST） in NP group and DP group were 10.3 months and 6.2 months respectively （x2 =2.987,P 〈 0.005）,and 1-year survival rates were 52.17% and 30.43% respectively （x2 =2.693,P 〈 0.005）.After chemotherapy,blood platelet number in DP group was （108.87 ± 15.63） x 109/L,lower than that in NP group （（128.17 ± 15.3） x 109/L,t =3.819,P 〈 0.05）.CD3 ＋,CD4 ＋,CD8 ＋,CD4 ＋/CD8 ＋ and NK cell rate in NP group before chemotherapy were （61.17 ±9.13）%,（36.99±7.83）%,（26.94 ±6.14）%,（1.93 ±0.21）%,（30.12 ±8.62）% respectively,and （52.82 ±8.19）%,（33.22 ±6.92）%,（23.21 ±5.64）%,（1.53 ±0.11）%,（28.07 ± 8.17）% after chemotherapy.There were significantly lower than that before chemotherapy significant （t =2.097,3.217,2.251,3.027,2.717;P 〈0.05）.CD3＋,CD4＋,CD8＋,CD4＋/CD＋ 8 and NK in DP group before chemotherapy were （62.82 ±9.13）%,（38.82 ±9.19）%,（27.81 ±7.97）%,（1.82 ±0.13）%,（31.82 ±7.48）% respectively,higher than that after chemotherapy （（50.76 ±8.19）%,（28.92 ±8.13）%,（20.82±8.93）%,（1.36±0.16）%,（29.12±7.31）%; t =2.347,2.591,3.857,2.438,2.157; P〈 0.05）.Compared with the DP group,CD4 ＋,CD8 ＋,CD4 ＋/CD8 ＋ in NP patients increased significantly （t =2.591,3.785,2.438 ; P 〈 0.05）.CD3 ＋,NK in two groups were not statistically significant （t =0.027,0.323 ;P 〉 0.05）.Conclusion The less decrease of the immune function was seen in terms of NP chemotherapy compared with DP of patients with advan