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斑蝥酸钠维生素B6对COPD合并NSCLC患者化学治疗联合免疫治疗预后的影响

Effects of Sodium Cantharidate and Vitamin B6 on the Prognosis of Chemotherapy Combined with Immunotherapy in Patients with COPD and NSCLC

    摘要
  • 摘要: 目的 探讨斑蝥酸钠维生素B6用于慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）合并非小细胞肺癌（non-small cell lung cancer，NSCLC）患者化学治疗（简称“化疗”）联合免疫治疗时对患者免疫功能及预后的影响。方法 选择2023年8月至2024年12月张家口市第一医院接诊的80例接受化疗联合免疫治疗的COPD合并NSCLC患者作为研究对象。对照组受试者接受紫杉醇+顺铂+信迪利单抗治疗，观察组受试者在对照组基础上加用斑蝥酸钠维生素B6治疗，2组均连续治疗4个周期。比较2组的临床疗效、免疫功能、肺功能、炎症因子，以及12个月的生存率。结果 治疗4个周期后，观察组的总缓解率高于对照组（P＜0.05）。治疗2和4个周期后，2组的分化簇（cluster of differentiation，CD）3阳性T细胞（CD3 positive T cell，CD3+T）比例、CD4+T比例、CD4+T/CD8+T比值，以及一氧化碳弥散量（diffusing capacity of the lung for carbon monoxide，DLCO）、第1秒用力呼气容积（forced expiratory volume in one second，FEV1）、用力肺活量（forced vital capacity，FVC）与IL-2水平高于治疗前（P＜0.05），且观察组高于对照组（P＜0.05）。治疗2和4个周期后，2组的单核细胞趋化蛋白-1(monocyte chemotactic protein-1，MCP-1)、IL-8水平降低（P＜0.05），且观察组低于对照组（P＜0.05）。观察组12个月生存率较对照组高，但2组比较差异无统计学意义（P ＞0.05）。结论 斑蝥酸钠维生素B6对行化疗联合免疫治疗的COPD合并NSCLC患者具有较好的临床效果，可改善患者的免疫功能、肺功能，降低炎症因子水平。

     

    Abstract: Objective To investigate the effects of sodium cantharidate and vitamin B6 on immune function and prognosis in patients with chronic obstructive pulmonary disease (COPD) and non-small cell lung cancer (NSCLC) undergoing chemotherapy combined with immunotherapy. Methods A total of 80 patients with COPD and NSCLC who received chemotherapy combined with immunotherapy at Zhangjiakou First Hospital from August 2023 to December 2024 were enrolled. The control group received paclitaxel + cisplatin + sintilimab, while the intervention group received sodium cantharidate and vitamin B6 in addition to the control group's regimen. Both groups were treated continuously for 4 cycles. The clinical efficacy, immune function, pulmonary function, inflammatory factors, and 12- month survival rate were compared between the two groups. Results After treatment, the overall response rate in the intervention group was higher than that in the control group (P＜0.05). After 2 and 4 cycles of treatment, the proportions of cluster of differentiation (CD) 3-positive T cells (CD3+ T) and CD4+ T, the CD4+ T/CD8+ T ratio, diffusing capacity of the lung for carbon monoxide (DLCO), forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and IL-2 levels in both groups were higher than before treatment (P＜0.05), and those in the intervention group were higher than in the control group (P＜0.05). After 2 and 4 cycles of treatment, the monocyte chemotactic protein-1 (MCP-1) and IL-8 levels in both groups decreased (P＜0.05), and those in the intervention group were lower than in the control group (P＜0.05). The 12-month survival rate in the intervention group was higher than that in the control group; however, no statistically significant difference was found between groups (P ＞0.05). Conclusion Sodium cantharidate and vitamin B 6 demonstrates favorable clinical efficacy in patients with COPD and NSCLC treated with chemotherapy combined with immunotherapy. It can improve the immune function and lung function of patients, and reduce the level of inflammatory factors.

     

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