摘要
目的 研究胸部受电离辐射后外周血细胞的变化特点。方法 选取１９９７ ～１９９８ 年非小细胞肺癌患者３０ 例。按１∶２ 配比年龄相似，性别相同的非放疗慢性病患者作为对照组。观察胸部外照射对外周血白细胞、淋巴细胞、血小板数的影响。ＮＳＣＬＣ以医用直线加速器６ ＭＶ－ Ｘ 线，常规分割放射治疗。射野包括肿瘤及其周围１ ～２ｃｍ 正常肺组织，同侧肺门以及纵膈，有时包括锁骨上区ＦＳＺ（Ｆｉｅｌｄｓｑｕａｒｅｚｏｏｍ） ７２ ～２４６ｃｍ２ ，剂量率２Ｇｙ／ｍｉｎ ，ＳＳＤ１００ｃｍ 。采用ＳＷＧＥＡＢＡＣ－ ９２０ 型血液细胞自动分析仪检测外周血白细胞、淋巴细胞、血小板数，并严格质量控制。结果 当吸收剂量１０Ｇｙ／５ｆ／ Ｗ ，ＮＳＣＬＣ外周血细胞数量开始下降；至２０ ～３０Ｇｙ／１０ ～１５ｆ／２ ～３ Ｗ 时，其外周血细胞数量降至低谷。并且上述３ 种细胞数量较之放疗前和对照组具有显著差异（ｔ＞ ２．５８ ，Ｐ＜ ０．０１）。另外，局部照射野＞ １００ｃｍ２ 组外周血白细胞数显著低于照射野为＜ １００ｃｍ２ 组，（ Ｆ＝６ ．４６，Ｐ＜ ０ ．０１）。在缩野和改侧斜野，放疗第四周（Ｄｔ＝ ４０Ｇｙ） 后，局部受损骨髓开始修复。
Objective The variation character of peripheral blood cell number in NSCLC casses during radiation therapy were investigated.Method From April,1997 to May.30,1998 patients with NSCLC were hospitalized.They were matched with patients sufferring from chronic diseases who were taken as the controls,who had the same sex,similar ages and similar occupation as that in the NSCLC group.The 6MV photon was used for NSCLC radiation therapy.The radiation fields covered the primary tumor,mediastinum and ipsilateral hilus of the lung.The SWGEB.AC920 automatic blood analysis instument was used for measuring peripheral blood cells in patients.Results In the last week of radiation therapy the dose was 10 Gy,the number of peripheral blood cells in patiente with NSCLC decreased significantly.In the 2nd week of trentment the namber of peripheral blood by leucoeytes in NSCLC declered into 4.48±1.63(×10 9/L),( x±s ),and in the 3rd week the number was 4.75± 1.94 (×10 9/L).There was significant difference compared with the controls ( t>2.58,P <0.01).Furthermore,the number of leucocyles in the case of FSZ being greater than 100 cm 2 was different obviously from the case in which FSZ was less than 100 cm 2 ( F =4.64, P <0.01) After the FSZ of NSCLC cases being narrowed,the amounts of peripheral blood cells raised gradually into 5.5.3±1.35(×10 9/L),and no difference compared with the controls.It suggests that the CFU cells from not damaged bone narrows immigrated into the injured bone narrows and began to help repair of radiation damage as well as production of blood cells.Conclusions In 2nd to 3ed week of radiation therapy,the amounts of peripheral blood cells declined obviously.Meanwhile the immunological function of NSCLC patients was too weak to prevent the bodies from infection.Therefore in the early stage of radiation therapy of NSCLC patients remedies and treatment should be made to suit radiobiological reaction.
出处
《苏州医学院学报》
2000年第1期48-50,56,共4页
Acta Academiae Medicinae Suzhou
