张楚荣

[摘要]目的 探討培美曲塞联合奈达铂化疗方案在晚期肺腺癌患者中的应用效果。方法 选取2017年4月～2019年3月就诊于我院的80例晚期肺腺癌患者作为研究对象，采用随机数字表法将其分为对照组与研究组，每组各40例。对照组患者采用多西他赛联合奈达铂化疗方案治疗，研究组患者采用培美曲塞联合奈达铂化疗方案治疗。比较两组患者的治疗效果、T淋巴细胞（CD3+、CD4+、CD8+、CD4+/CD8+）和不良反应总发生率。结果 两组患者的治疗总有效率比较，差异无统计学意义（P>0.05）;化疗4个周期后，两组患者的CD3+、CD4+、CD4+/CD8+高于化疗前，CD8+低于化疗前，且研究组患者的CD3+、CD4+、CD4+/CD8+高于对照组，CD8+低于对照组，差异有统计学意义（P<0.05）;研究组患者的不良反应总发生率低于对照组，差异有统计学意义（P<0.05）。结论 培美曲塞、多西他赛分别联合奈达铂治疗晚期肺腺癌的临床疗效相当，但培美曲塞联合奈达铂化疗方案可增强患者的免疫功能，不良反应较少，值得临床推广应用。

[关键词]晚期肺腺癌;培美曲塞二钠;多西他赛;奈达铂;不良反应

[中图分类号] R734.2          [文献标识码] A          [文章编号] 1674-4721（2020）7（b）-0116-04

Application effect of Pemetrexed Disodium and Docetaxel in combination with Nedaplatin in the treatment of advanced lung adenocarcinoma

ZHANG Chu-rong

Department of Oncology， the Second People′s Hospital of Zhaoqing City， Guangdong Province， Zhaoqing   526000， China

[Abstract] Objective To explore the effect of Pemetrexed Disodium and Docetaxel in combination with Nedaplatin in the treatment of advanced lung adenocarcinoma. Methods A total of 80 patients with advanced lung adenocarcinoma who were treated to our hospital from April 2017 to March 2019 were selected as the research objects. According to the random number table method， the research objects were divided into control group and study group， 40 cases in each group. The control group was treated with Docetaxel plus Nedaplatin. The study group was treated with Pemetrexed Disodium in combination with Nedaplatin. The treatment effect， T lymphocytes （CD3+、CD4+、CD8+、CD4+/CD8+） and total incidence of adverse reactions were compared between the two groups. Results The total effective rate of treatment between the two groups of patients was not statistically significant （P>0.05）. After 4 cycles of chemotherapy， the CD3+， CD4+， CD4+/CD8+ of the two groups of patients were higher than those before chemotherapy， and CD8+ was lower than that before chemotherapy， and the CD3+， CD4+， CD4+/CD8+ of the study group were higher than those in the control group， and CD8+ was lower than that in the control group， the differences were statistically significant （P<0.05）. The total incidence of adverse reactions in the study group was lower than that in the control group， the difference was statistically significant （P<0.05）. Conclusion The clinical effect of Pemetrexed Disodium and Docetaxel in combination with Nedaplatin in the treatment of advanced lung adenocarcinoma is comparable， but Pemetrexed Disodium combined with Nedaplatin can enhance the immune function of patients， less adverse reactions， worthy of clinical application.

[Key words] Advanced lung adenocarcinoma; Pemetrexed disodium; Docetaxel; Nedaplatin; Adverse reactions

肺腺癌是一種非小细胞癌，多发于不抽烟者或女性中，胸部X线或CT检查可见椭圆形或圆形包块，早期无明显病症，发现时多为晚期，易导致患者出现疼痛、声音嘶哑、颈部水肿、胸腔积液、气促等症状，危及患者生命安全[1-2]。临床上，治疗晚期肺腺癌患者多采用化疗方式，铂类药物联合培美曲塞或多西他赛是常见的治疗方法。奈达铂属于第3代铂类抗肿瘤药物，抗癌谱较广，对小细胞肺癌、头颈部癌、食管癌、卵巢癌等均有活性，具有毒副作用小、水溶性好的优势，联合其他化疗药物可有效减少癌细胞，改善患者病症[3]。多西他赛是一种疗效显著的抗癌药物，以微管为靶点，可以诱导癌细胞凋亡，抑制肿瘤血管的形成，进而使癌细胞失去活性，达到抗癌的目的[4]。培美……