【摘要】 目的:探讨术前胸腺肽α₁新辅助化疗对老年食管癌患者术后免疫功能的影响。方法:选取Ⅱ、Ⅲ期老年食管癌患者46例为研究对象,随机分为对照组与治疗组组,各23例,所有患者术前均进行常规DP（多西他赛+奈达帕）方案化疗,治疗组采用DP结合胸腺肽α₁新辅助化疗方案,而对照组只采用常规DP方案化疗,分别于化疗前1天、化疗1周期、2周期后及手术后7 d抽取患者外周血,采用流式细胞技术检测NK细胞含量变化及T细胞亚群（CD4+、CD8+、CD4+/CD8+、CD3+）的百分率。结果:化疗1周期、2周期及术后7 d,治疗组CD3+、CD4+、CD8+、CD4+/CD8+水平显著高于对照组,差异有统计学意义（P<0.05）,且2周期化疗和术后7 d后,治疗组NK细胞含量显著高于对照组,差异有统计学意义（P<0.05）,治疗组CD3+、CD4+、CD8+、CD4+/CD8+水平较前增加幅度显著;在粒细胞减少上,治疗组更显著低于对照组,差异有统计学意义（P=0.001）,治疗组化疗不良反应显著低于对照组,差异有统计学意义（P<0.05）;治疗组肺部感染发生率显著低于对照组,差异有统计学意义（P<0.05）;在术后并发症方面,两组总发生率差异无统计学意义（P=0.356）。结论:胸腺肽α₁新辅助化疗应用于Ⅱ、Ⅲ期老年食管癌术后,可有效提高患者对化疗及手术的耐受性,增强患者免疫功能,不良反应小,有利于改善患者生活质量。更多还原

【Abstract】 Objective To investigate the effect of neoadjuvant chemotherapy in elderly patients with esophageal cancer after operation. Method Forty-six patients with esophageal cancer were selected and randomly divided into two groups(n = 23) and control group(n = 23). The control group was treated with surgery. Post-neoadjuvant chemotherapy. The peripheral blood of the patients was taken 1 week before chemotherapy,1 week after chemotherapy,2 cycles and 7 days after operation. Flow cytometry(FCM) was used to detect the changes of NK cells. The expression of T cell subsets(CD4+,CD8+,CD4+/CD8+,CD3+). Results The levels of CD3+,CD4+,CD8+,CD4+/CD8+in the treatment group were significantly higher than those in the control group(P < 0. 05),and 2 cycles of chemotherapy and chemotherapy the levels of CD3+,CD4+,CD8+,CD4+/CD8+in the treatment group were significantly higher than those in the control group(P < 0. 05). After 7 days,the levels of NK cells in the treatment group were significantly higher than those in the control group(P < 0. 05). In the case of granulocytic reduction,the treatment group was significantly lower than that in the control group(P = 0. 01). The incidence of pulmonary infection in the treatment group was significantly lower than that in the control group(P < 0. 05) The overall incidence of postoperative complications was not statistically significant(P = 0. 356). Conclusion Neoadjuvant chemotherapy is applied to the patients with esophageal cancer in stage Ⅱ and Ⅲ,which can improve the patient’s immune function and improve the immune function,and the adverse reaction is small,which is helpful to improve the quality of life of patients.更多还原