伊班膦酸钠联合化疗对非小细胞肺癌骨转移患者炎性因子及骨代谢指标的影响

Effect of ibanphosphate combined with chemotherapy on inflammatory factors and bone metabolism indicators in non-small cell lung cancer patients with bone metastasis

  • 摘要:
      目的  探讨伊班膦酸钠联合化疗对非小细胞肺癌(NSCLC)骨转移患者炎性因子及骨代谢指标的影响。
      方法  选取120例NSCLC骨转移患者作为研究对象,其中肺腺癌患者采用培美曲塞、卡铂联合伊班膦酸钠治疗,肺鳞癌患者采用注射用紫杉醇脂质体或注射用白蛋白紫杉醇、卡铂联合伊班膦酸钠治疗,均化疗2个周期。比较化疗前和化疗2个周期后患者炎性因子血清C反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平、骨代谢指标(血清骨钙素氨基中分子片段、Ⅰ型前胶原氨基端肽、Ⅰ型胶原羧基端肽β特殊序列、骨特异性碱性磷酸酶)水平、骨痛评分和不良反应发生情况。
      结果  化疗2个周期后,患者CRP、PCT、TNF-α、IL-6水平和Ⅰ型胶原羧基端肽β特殊序列水平均低于化疗前,血清骨代谢指标骨钙素氨基中分子片段、Ⅰ型前胶原氨基端肽、骨特异性碱性磷酸酶水平均高于化疗前,差异有统计学意义(P < 0.05)。化疗2个周期后,患者骨痛评分为(2.47±1.79)分,低于化疗前的(15.56±3.89)分,差异有统计学意义(P < 0.05)。化疗期间发生发热8例、恶心10例、呕吐13例、骨髓抑制7例,不良反应发生率为31.67%。
      结论  伊班膦酸钠联合化疗可显著降低NSCLC骨转移患者血清炎性因子水平,改善血清骨代谢指标水平,且具有良好的应用安全性。

     

    Abstract:
      Objective  To investigate the effect of ibanphosphate combined with chemotherapy on inflammatory factors and bone metabolism indicators in non-small cell lung cancer(NSCLC) patients with bone metastasis.
      Methods  A total of 120 NSCLC patients with bone metastasis were included in this study. Patients with lung adenocarcinoma were treated with pemetrexed, carboplatin combined with ibandronate sodium, and those with lung squamous cell carcinoma were treated with paclitaxel liposome for injection or albumin paclitaxel for injection, all patients underwent 2 cycles of chemotherapy. The levels of inflammatory factors such as serum C-reactive protein (CRP), procalcitonin (PCT), tumor necrosis factor (TNF-α), interleukin-6 (IL-6), bone metabolic indexes such as amino intermediate fragment of osteocalcin, amino terminal peptide of type Ⅰ procollagen, carboxy terminal peptide of type Ⅰ collagen β special sequence, bone specific alkaline phosphatase, bone pain score and incidence of adverse reactions were compared before and after chemotherapy.
      Results  After 2 cycles of chemotherapy, the levels of CRP, PCT, TNF-α, IL-6 and the carboxy terminal peptide of type Ⅰ collagen β special sequence were significantly lower than those before chemotherapy, amino intermediate fragment of osteocalcin, amino terminal peptide of type Ⅰ procollagen and bone specific alkaline phosphatase were significantly higher than those before chemotherapy(P < 0.05). The score of bone pain was (15.56±3.89) before chemotherapy and (2.47±1.79) after 2 cycles of chemotherapy, and the score of bone pain after 2 cycles of chemotherapy was significantly lower than that before chemotherapy (P < 0.05). There were 8 cases of fever, 10 cases of nausea, 13 cases of vomiting and 7 cases of bone marrow suppression, with the incidence of adverse reactions of 31.67%.
      Conclusion  Ibanphosphate combined with chemotherapy can significantly reduce the level of serum inflammatory factors in NSCLC patients with bone metastasis, improve the serum bone metabolism indexes, and has good application safety.

     

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