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目的:观察乌司他丁对非小细胞肺癌患者放疗后放射性肺损伤的防治作用。方法:120例非小细胞肺癌患者随机双盲分入试验组和对照组,试验组在放疗开始前3 d及放疗中前7 d接受乌司他丁治疗,同时对照组患者使用安慰剂治疗。在放疗开始前,放疗后第4,8,16,24周时检测患者血清中TGF-β1,IL-6和TNF-α水平。观察放疗后放射性肺损伤发生率及程度。患者在放疗开始前,放疗后第8,24周时行肺功能评估。结果:放疗后试验组患者血清中TGF-β1,IL-6和TNF-α水平明显低于对照组,特别是在前4周。放疗后试验组患者放射性损伤发生率及程度以及FEV1,DLCO和FVC等指标下降程度明显低于对照组,第8周时试验组FVC值明显低于对照组,在24周时FEV1,DLCO和FVC下降程度明显低于对照组。试验组患者生存周期及放疗效果无明显差异。结论:乌司他丁能有效降低非小细胞肺癌患者放疗后血清中TGF-β1,IL-6和TNF-α水平。而且能有效降低非小细胞肺癌患者放疗后放射性肺损伤发生率并减轻肺功能下降程度。
Objective: To observe the preventive and therapeutic effects of ulinastatin on radiation-induced lung injury in patients with non-small cell lung cancer after radiotherapy. Methods: One hundred and twenty non-small cell lung cancer patients were randomly divided into experimental group and control group. The experimental group received ulinastatin 3 days before radiotherapy and 7 days before radiotherapy, while the control group received placebo. Serum levels of TGF-β1, IL-6 and TNF-α were measured before radiotherapy and 4, 8, 16 and 24 weeks after radiotherapy. Observe the incidence and extent of radiation-induced lung injury after radiotherapy. Patients before radiotherapy, radiotherapy at week 8,24 lung function assessment. Results: The serum levels of TGF-β1, IL-6 and TNF-α in the experimental group after radiotherapy were significantly lower than those in the control group, especially in the first 4 weeks. After radiotherapy, the incidence and extent of radiation injury in experimental group and the decrease of FEV1, DLCO and FVC were significantly lower than those in control group. The FVC value of experimental group was significantly lower than that of control group at the 8th week. FEV1, DLCO and FVC Decreased significantly lower than the control group. There was no significant difference in the survival period and radiotherapy effect in the experimental group. Conclusion: Ulinastatin can effectively reduce the serum levels of TGF-β1, IL-6 and TNF-α in patients with non-small cell lung cancer after radiotherapy. But also can effectively reduce the incidence of radiation-induced lung injury after radiotherapy and reduce the decline of lung function in patients with non-small cell lung cancer.