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目的观察痰热清注射液防治放射性肺损伤的临床疗效及对基质金属蛋白酶9(MMP-9)的影响。方法将90例需要进行放射治疗的肺癌患者随机分为二组,观察组42例放射治疗同时予痰热清注射液静滴;对照组48例只予常规放射治疗。于放射治疗开始后1h、24h和72h、1周(潜伏期)、2周、4周、8周、16周(肺炎期)、24周(肺纤维化期)抽空腹静脉血,用酶联免疫吸附法(ELISA法)测定血清MMP-9的含量。结果急性放射性肺炎总发生率观察组为23.81%,对照组为35.42%;3、4级肺炎发生率观察组7.14%,对照组35.71%;3、4级肺炎平均发病剂量分别为60Gy和55Gy;放射性肺炎平均发病时间分别为42d和30d;肺纤维化发生率观察组为26.19%,对照组为56.25%。观察组血清MMP-9的含量较对照组高,且下降趋势缓慢。结论痰热清注射液能改变血清MMP-9的表达,有效预防和推迟严重性急性放射性肺炎及肺纤维化的发生;对减轻放射性肺损伤、提高生存质量、保证放射治疗的顺利进行具有积极意义。
Objective To observe the clinical efficacy of Tanreqing Injection in preventing and treating radiation-induced lung injury and its effect on matrix metalloproteinase-9 (MMP-9). Methods Ninety patients with lung cancer who needed radiotherapy were randomly divided into two groups. In the observation group, 42 patients received intravenous injection of Tanreqing injection simultaneously. In the control group, 48 patients received routine radiotherapy. Fasting venous blood was drawn at 1 h, 24 h and 72 h, 1 week (latency), 2 weeks, 4 weeks, 8 weeks, 16 weeks (pneumonitis) and 24 weeks Adsorption method (ELISA method) determination of serum MMP-9 content. Results The total incidence of acute radiation pneumonitis was 23.81% in the observation group and 35.42% in the control group. The incidence of grade 3 and 4 pneumonia was 7.14% in the observation group and 35.71% in the control group. The average incidences of 3 and 4 pneumonia were 60 Gy and 55 Gy, respectively. The average incidence of radiation pneumonitis were 42d and 30d respectively; the incidence of pulmonary fibrosis in the observation group was 26.19% and that in the control group was 56.25%. The serum level of MMP-9 in the observation group was higher than that in the control group, and the decline trend was slow. Conclusion Tanreqing injection can change the expression of serum MMP-9, effectively prevent and delay the occurrence of severe acute radiation pneumonitis and pulmonary fibrosis, and has positive significance in reducing radiation-induced lung injury, improving quality of life and ensuring the smooth progress of radiation therapy .