【摘要】 目的探究¹²⁵碘粒子植入联合肿瘤切除术治疗脑胶质瘤的临床效果及对患者血清miR-128、miR-29c表达的影响。方法选取2015年3月-2018年3月于郴州市第一人民医院神经外科接受治疗的脑胶质瘤患者80例,按照随机数字表法分为对照组和观察组,每组各40例。对照组患者给予开颅肿瘤切除术,观察组患者在对照组的基础上给予¹²⁵碘粒子植入治疗。荧光定量PCR法检测血清中miR-128和miR-29c表达水平,选用KPS功能状态评分对患者的功能状态进行衡量,比较2组患者的不良反应发生情况。结果观察组患者治疗总有效率为95. 00%,显著高于对照组的80.00%,差异具有统计学意义（χ²=4.114,P=0.043）。肿瘤分化程度Ⅰ～Ⅱ级患者血清miR-128表达高于Ⅲ～Ⅳ级患者（χ²=3.643,P=0.000）,miR-29c表达水平低于Ⅲ～Ⅳ级患者（χ²=3.934,P=0.000）。治疗后,2组患者血清中miR-128水平均降低,miR-29c水平均升高,且观察组的变化明显优于对照组,差异有统计学意义（t/P=3.468/0.001,t/P=5.926/0.000）。治疗后2组患者KPS评分均明显提高,且观察组患者的KPS评分显著高于对照组,差异具有统计学意义（t=8. 519,P=0. 000）。观察组患者的不良反应发生率为5. 00%,显著低于对照组的20.00%,差异有统计学意义（χ²=4.114,P=0.043）。结论采用¹²⁵碘粒子植入联合肿瘤切除术治疗脑胶质瘤的效果明显优于单独采用肿瘤切除术,不仅可以改善患者血清中miR-128、miR-29c的表达水平,且不良反应发生率较低。更多还原

【Abstract】 Objective To explore the clinical effect of iodine 125(I¹²⁵) seeds implantation combined with tumor resection in the treatment of glioma and the influence on the expression of serum miR-128 and miR-29c. Methods Eighty patients with glioma who were treated in neurosurgery department of Chenzhou First People’s Hospital from March 2015 to March2018 were divided into control group and observation group according to random number table method, 40 cases in each group.The patients in the control group were treated with craniotomy and the patients in the observation group were treated with I¹²⁵seeds implantation on the basis of the control group. The expression levels of miR-128 and miR-29 c in serum were detected by fluorescence quantitative PCR. The functional status of patients was measured by KPS functional status score, and adverse reactions were compared between the two groups. Results The total effective rate of the observation group was 95.00%, which was significantly higher than that of the control group（80.00%,χ² = 4.114,P = 0. 043）. The expression of serum miR-128 in patients with grade Ⅰ to Ⅱ was higher than that in patients with grade III to IV（χ² = 3.643,P =0.000）, and the expression of miR-29 c in patients with grade Ⅲ to Ⅳ was lower than that in patients with grade Ⅲ to Ⅳ（χ² = 3.934,P =0.000）. After treatment, the levels of serum miR-128 in both groups decreased, and the levels of miR-29c increased. The changes in the observation group were significantly better than those in the control group（t/P = 3. 468/0. 001, t/P = 5. 926/0. 000）. After treatment, the KPS scores of the two groups were significantly improved, and the KPS scores of the observation group were significantly higher than those of the control group, the difference was statistically significant（t=8.519,P = 0.000）. The incidence of adverse reactions in the observation group was 5. 00%, significantly lower than that in the control group（20. 00%,χ²=4. 114,P = 0. 043）. Conclusion The effect of I¹²⁵ seeds implantation combined with tumor resection in the treatment of glioma is obviously better than that of tumor resection alone. It can not only improve the expression level of serum miR-128 and miR-29 c, but also reduce the incidence of adverse reactions.更多还原