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[目的]探讨重组人白细胞介素-12(recombinant human interleukin-12,rhIL-12)在胰腺癌放射治疗放射防护中发挥的作用。[方法]回顾性分析52例胰腺癌患者,根据治疗方式分为单纯放疗组和rhIL-12+放疗组。两组患者均采用射波刀治疗,放射剂量30~35Gy,r IL-12+放疗组放疗后予以150ng/kg rhIL-12干预治疗。两组分别于0h、12h、3d、7d、14d、21d、28d采用流式细胞术检测两组患者细胞免疫功能相关指标CD4/CD8比值、CD45、CD56数值变化;ELISA法检测血清细胞因子IFN-γ表达水平;分析评价两组患者外周血细胞计数变化、近期治疗疗效和胃肠道相关不良反应。[结果]rhIL-12+放疗组患者免疫相关分子CD4/CD8比值、CD45和CD56表达12h内均存在一过性降低现象,随治疗时间的推移逐渐回升,于治疗第14d达到峰值且恢复,改善趋势明显优于单纯放疗组(P<0.05);细胞因子IFN-γ表达随时间变化逐渐递增,于14d达峰值,较单纯放疗组具有显著性差异(P<0.05)。血液标本检测显示两组患者治疗前红细胞(RBC)、白细胞(WBC)、血小板(PLT)、中性粒细胞(NEUT)计数以及血红蛋白(Hb)含量均无显著性差异(P>0.05);在治疗14d时rhIL-12+放疗组患者WBC、PLT和NEUT计数较单纯放疗组均具显著性差异(P<0.05),而RBC计数和Hb含量则差异无统计学意义(P>0.05);rhIL-12+放疗组患者近期治疗疗效显著(P=0.046);两组患者胃肠道不良反应主要表现为恶心呕吐和腹泻,rhIL-12+放疗组发生率均低于单纯放疗组(P=0.001;P=0.012)。[结论]rhIL-12可有效地促进胰腺癌放射治疗患者造血功能和免疫机能的恢复和重建,并能降低放射治疗不良反应的发生率,提高治疗疗效。
[Objective] To investigate the role of recombinant human interleukin-12 (rhIL-12) in the radioprotection of pancreatic cancer. [Methods] A total of 52 patients with pancreatic cancer were retrospectively analyzed. Patients were divided into radiotherapy group and rhIL-12 + radiotherapy group according to the treatment method. The two groups of patients were treated with radiosurgery, radiation dose 30 ~ 35Gy, r IL-12 + radiotherapy group after radiotherapy 150ng / kg rhIL-12 intervention. The levels of CD4 / CD8, CD45 and CD56 in the two groups were detected by flow cytometry at 0h, 12h, 3d, 7d, 14d, 21d and 28d respectively. Serum cytokine IFN- γ expression levels; analysis of two groups of patients with peripheral blood cell count changes, the recent treatment efficacy and gastrointestinal adverse reactions. [Results] The immune-related molecules CD4 / CD8 ratio, CD45 and CD56 expression in rhIL-12 + radiotherapy group all had a transient decrease within 12 hours, gradually rose with the passage of treatment time, reached the peak on the 14th day of treatment and recovered and improved (P <0.05). The expression of cytokine IFN-γ gradually increased with time and reached its peak on the 14th day, which was significantly different from that of the radiotherapy alone group (P <0.05). Blood samples showed no significant difference in the counts of erythrocytes (RBC), white blood cells (WBC), platelets (PLT), neutrophils (NEUT) and hemoglobin before treatment in both groups (P> 0.05) The counts of WBC, PLT and NEUT in rhIL-12 + radiotherapy group were significantly higher than those in radiotherapy alone group on the 14th day after treatment (P <0.05), while there was no significant difference between RBC count and Hb content (P> 0.05) (P = 0.046). The gastrointestinal adverse reactions in the two groups were mainly nausea, vomiting and diarrhea. The incidence of rhIL-12 + radiotherapy group was lower than that of the radiotherapy alone group (P = 0.001) ; P = 0.012). [Conclusion] rhIL-12 can effectively promote the recovery and reconstruction of hematopoietic function and immune function in patients with radiation therapy of pancreatic cancer, and can reduce the incidence of adverse reactions and improve the curative effect.