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目的对比研究中晚期胃癌术后化疗中卡培他滨联合奥沙利铂与亚叶酸钙、氟尿嘧啶联合奥沙利铂的临床疗效及T淋巴细胞亚群的影响。方法选取2012年5月—2016年3月于本院就诊的共114例中晚期胃癌患者作为研究对象。按随机数字表法将所有患者分为两组,即对照组(n=48例)和研究组(n=66例),其中对照组患者采用亚叶酸钙、氟尿嘧啶联合奥沙利铂进行术后化疗,研究组患者采用卡培他滨联合奥沙利铂进行术后化疗。对比两组患者的T淋巴细胞亚群(CD8~+、CD4~+、CD3~+、CD4~+/CD25~+、CD4~+/CD8~+)变化、不良反应发生率、生存率和化疗疗程。计量资料采用t检验,计数资料采用χ~2检验,P<0.05为差异有统计学意义。结果两组患者化疗前对比差异无统计学意义(P>0.05),研究组化疗后的CD4~+、CD3~+、CD4~+/CD8~+明显高于对照组化疗后,且对比差异均有统计学意义(均P<0.05),且两组患者化疗后的CD4~+、CD3~+、CD4~+/CD25~+、CD4~+/CD8~+与化疗前对比差异均有统计学意义(均P<0.05)。研究组患者手足综合征发生率明显高于对照组,恶心、呕吐和白细胞减少发生率明显低于对照组,对比差异均有统计学意义(均P<0.05),神经毒性和腹泻发生率两组对比差异无统计学意义(P>0.05)。对照组平均化疗周期为(3.43±0.31)个周期,研究组患者平均化疗周期为(3.95±0.45)个周期,两组对比差异有统计学意义(P<0.05)。对照组患者一年生存率为60.42%,明显低于研究组的81.82%,两组对比差异有统计学意义(P<0.05);对照组患者无进展生存期为(6.6±3.0)个月,研究组患者无进展生存期为(9.2±2.4)个月,两组对比差异有统计学意义(P<0.05)。结论胃癌术后化疗中卡培他滨联合奥沙利铂不良反应小、对患者正常组织影响小、用药方便,且可改善机体免疫抑制状态,具有较好的临床治疗效果。
Objective To compare the clinical efficacy of Capecitabine combined with oxaliplatin with leucovorin, fluorouracil and oxaliplatin in the treatment of advanced gastric cancer and the effect of T lymphocyte subsets. Methods From May 2012 to March 2016, a total of 114 patients with advanced gastric cancer were selected as study subjects. All patients were divided into two groups according to the random number table method: the control group (n = 48) and the study group (n = 66). The patients in the control group were treated with leucovorin and fluorouracil combined with oxaliplatin Chemotherapy, the study group of patients with capecitabine combined with oxaliplatin postoperative chemotherapy. The changes of T lymphocyte subsets (CD8 +, CD4 +, CD3 +, CD4 + / CD25 +, CD4 + / CD8 +), incidence of adverse reactions, survival rate and chemotherapy in the two groups were compared Course of treatment. Measurement data using t test, count data using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results There was no significant difference between two groups before chemotherapy (P> 0.05). The levels of CD4 ~ +, CD3 ~ + and CD4 ~ + / CD8 ~ + in the study group were significantly higher than those in the control group after chemotherapy (All P <0.05). There was statistical difference between the two groups in the levels of CD4 ~ +, CD3 ~ +, CD4 ~ + / CD25 ~ + and CD4 ~ + / CD8 ~ Significance (all P <0.05). The incidence of hand-foot syndrome in the study group was significantly higher than that in the control group, and the incidence of nausea, vomiting and leukopenia was significantly lower in the study group than in the control group (all P <0.05). The incidence of neurotoxicity and diarrhea The difference was not statistically significant (P> 0.05). The average chemotherapy cycle in the control group was (3.43 ± 0.31) cycles, and the average chemotherapy cycle in the study group was (3.95 ± 0.45) cycles. The difference between the two groups was statistically significant (P <0.05). The one-year survival rate was 60.42% in the control group, which was significantly lower than 81.82% in the study group, with significant difference between the two groups (P <0.05). The progression-free survival rate in the control group was (6.6 ± 3.0) The progression-free survival rate in study group was (9.2 ± 2.4) months, with significant difference between the two groups (P <0.05). Conclusions The postoperative chemotherapy for caegative carcinoma has a small adverse effect of capecitabine combined with oxaliplatin, little effect on the normal tissue of the patients, convenient medication, and can improve the immunosuppressive state of the body, and has good clinical curative effect.