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急性放射性口腔炎患者唾液和外周血炎症细胞因子的变化及意义

沈红梅   

  1. 昆明医学院第三附属医院
  • 收稿日期:2012-03-05 修回日期:2012-06-14 出版日期:2012-11-15 发布日期:2012-11-15
  • 通讯作者: 沈红梅

The changes and clinical significance of inflammatory cytokines in saliva and peripheral blood of patients with acute radiation-induced stomatitis

  • Received:2012-03-05 Revised:2012-06-14 Published:2012-11-15 Online:2012-11-15

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摘要： [摘要] 目的 探讨鼻咽癌行根治性放疗的患者急性放射性口腔炎发生发展过程中唾液和外周血6种炎症细胞因子IFN-g、TNF-α、IL-2、IL-4、IL-6、IL-10的变化和临床意义。方法 于放疗剂量DT为0、40、70Gy时，检测40例鼻咽癌行根治性放疗的患者唾液和外周血中6种炎症细胞因子。结果 （1）在放疗剂量DT为0、40、70Gy时，唾液中IFN-g、TNF-α、IL-2、IL-4、IL-6、IL-10的水平均明显高于血液，差异有显著性（P＝0.000）。（2）唾液和血液中的IFN-g、TNF-α、IL-2、IL-4、IL-6、IL-10在放疗剂量达40Gy时均较放疗前明显升高（血液的IL-10P＝0.003，其余P＝0.000）。（3）放疗剂量达70Gy时唾液和血液除IL-10继续明显升高外（P＝0.000），IFN-g、TNF-α、IL-2、IL-6均显著低于放疗前（P＝0.000），IL-4水平在唾液明显低于放疗前（P＝0.000）。结论 在鼻咽癌行根治性放疗的患者急性放射性口腔炎发生发展过程中，唾液中IFN-g、TNF-α、IL-2、IL-4、IL-6、IL-10的水平均明显高于血液；除IL-4外，唾液和血液的5种炎症细胞因子发生了类似的变化，其变化符合口腔炎病理发展过程。

关键词: 放射性口腔炎, 唾液, 外周血, 炎症细胞因子

Abstract: [Abstract] Purpose: To investigate the changes and clinical significance of IFN-g、TNF-α、IL-2、IL-4、IL-6、IL-10 in the saliva and peripheral blood of the patients with nasopharyngeal carcinoma undergoing radical radiotherapy. Methods: At three doses of radiotherapy, including DT=0 Gy, DT=40 Gy and DT= 70 Gy, six kinds of inflammatory cytokines were examined in the saliva and peripheral blood of 40 patients with nasopharyngeal carcinoma undergoing radical radiotherapy. Results: (1)The levels of the six cytokines in saliva were remarkably higher than those in peripheral blood(P=0.000) at three doses of radiotherapy. (2)The levels of the 6 cytokines in both saliva and peripheral blood at DT=40Gy increased remarkably compared with those at DT=0 Gy (P(IL-10 in blood)=0.003, P=0.000). (3) The level of IL-10 increased in the saliva and peripheral blood at DT=70 Gy, whereas the levels of IFN-g、TNF-α、IL-2、IL-6 decreased compared with those at DT=0 Gy (P=0.000). The level of IL-4 in the saliva at DT=70 Gy was lower than that at DT=0 Gy (P=0.000), .Conclusion: On the progress of acute radiation-induced stomatitis of the patients with nasopharyngeal carcinoma undergoing radical radiotherapy, the levels of IFN-g、TNF-α、IL-2、IL-4、IL-6、IL-10 in the saliva were remarkably higher than those in peripheral blood. Except IL-4, the change of the five cytokines was similar in saliva and blood, which were associated with the pathogenesis of stomatitis.

Key words: Radiation-induced stomatitis, Saliva, Peripheral blood, Inflammatory cytokines