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目的淋巴细胞及炎症因子在胆囊癌患者中表达异常,本研究通过研究替吉奥联合卡培他滨对胆囊癌患者炎性因子和淋巴细胞功能的影响,探讨其临床治疗机制。方法将丽水市中心医院2014年2月—2015年10月收治的84例胆囊癌患者按照随机数字表法分为试验组(42例)和对照组(42例),对照组采用卡培他滨口服治疗,1.5 g/m~2,2次/d,试验组加用替吉奥口服治疗,50 mg/m~2,2次/d,8周后观察2组患者的临床疗效、临床受益情况和毒副反应。采用ELISA法检测血清TNF-α、IL-6、IL-8炎性因子水平,流式细胞仪测定T细胞亚群CD4~+、CD8~+细胞,分析其变化情况。结果试验组的总有效率为52.38%(22/42),对照组总有效率为33.33%(14/42),秩和检验差异无统计学意义(P>0.05)。试验组的肿瘤控制率为78.57%(33/42),显著高于对照组的57.14%(24/42),差异有统计学意义(P<0.05)。试验组患者的TNF-α、IL-6、IL-8水平低于对照组,差异有统计学意义(P<0.05)。试验组患者的T细胞CD4~+、CD8~+高于对照组,差异有统计学意义(P<0.05)。2组患者主要不良反应为皮疹、恶心呕吐、肝功能损害,差异无统计学意义(P>0.05)。结论替吉奥联合卡培他滨治疗胆囊癌患者疗效较好,降低炎症反应,增强机体免疫功能,不良反应较轻,值得临床推广应用。
Objective Lymphocytes and inflammatory cytokines are abnormally expressed in gallbladder cancer patients. In this study, we investigated the effect of treatment of capecitabine on the inflammatory cytokines and lymphocyte function in patients with gallbladder cancer and explored its clinical therapeutic mechanism. Methods Eighty-four patients with gallbladder cancer admitted from February 2014 to October 2015 in Lishui Central Hospital were randomly divided into experimental group (n = 42) and control group (n = 42). The control group was treated with capecitabine Oral treatment, 1.5 g / m ~ 2, 2 times / d, the test group plus tige orally, 50 mg / m ~ 2,2 times / d, 8 weeks after the observation of the clinical efficacy of two groups of patients, clinical benefit Situation and side effects. Serum levels of TNF-α, IL-6 and IL-8 were measured by ELISA. CD4 + and CD8 + T cell subsets were detected by flow cytometry and their changes were analyzed. Results The total effective rate was 52.38% (22/42) in the test group and 33.33% (14/42) in the control group. The rank sum test showed no significant difference (P> 0.05). The tumor control rate of the experimental group was 78.57% (33/42), which was significantly higher than that of the control group (57.14%, 24/42), the difference was statistically significant (P <0.05). The levels of TNF-α, IL-6 and IL-8 in the experimental group were significantly lower than those in the control group (P <0.05). The CD4 ~ +, CD8 ~ + of T cells in experimental group were higher than those in control group, the difference was statistically significant (P <0.05). The main adverse reactions of the two groups were rash, nausea and vomiting, liver damage, the difference was not statistically significant (P> 0.05). Conclusions The treatment of gallbladder cancer in patients with GGO combined with capecitabine has good curative effect, reduces the inflammatory reaction and enhances the immune function of the body with less adverse reactions, which is worthy of clinical application.