目的 探討唑來膦酸聯(lián)合化療對(duì)非小細(xì)胞肺癌（NSCLC）骨轉(zhuǎn)移臨床療效及炎性因子水平的影響。方法 研究時(shí)間為2015年6月-2017年8月，采用回顧性研究方法，選擇在重慶市開州區(qū)人民醫(yī)院診治的NSCLC骨轉(zhuǎn)移患者102例，根據(jù)治療方法的不同分為觀察組52例與對(duì)照組50例，對(duì)照組給予含鉑類方案化療，觀察組在對(duì)照組治療的基礎(chǔ)上給予唑來膦酸治療，兩組都治療觀察4周。觀察比較兩組的臨床療效、骨痛評(píng)分、炎癥因子及不良反應(yīng)情況。結(jié)果 觀察組的總有效率為84.6%，顯著高于對(duì)照組的52.0%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后觀察組與對(duì)照組的骨痛評(píng)分都顯著低于治療前，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組的評(píng)分也顯著低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后兩組的血清腫瘤壞死因子-α（TNF-α）水平顯著低于治療前，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組也顯著低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組治療期間的不良反應(yīng)分別為發(fā)熱、寒顫、骨髓抑制、胃腸道反應(yīng)，兩組對(duì)比差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 唑來膦酸聯(lián)合化療在NSCLC骨轉(zhuǎn)移中的應(yīng)用能提高臨床療效與緩解疼痛，且不會(huì)增加不良反應(yīng)的發(fā)生，其作用機(jī)制與降低炎性因子表達(dá)水平有關(guān)。

Objective To investigate the effects of zoledronic acid combined with chemotherapy on the clinical efficacy and inflammatory factors in patients with non-small cell lung cancer (NSCLC) with bone metastases. Methods From June 2015 to August 2017, 102 patients of NSCLC bone metastases were selected in our hospital and were divided into the 52 patients in the observation group and the 50 patients in the control group accorded to the different treatment methods. The control group were given the platinum group therapy, the observation group were treated with zoledronic acid on the basis of the control group, and the two groups were treated for 4 weeks. Results The total effective rate in the observation group were 84.6%, which were significantly higher than that in the control group (72%) (P<0.05). After treatment, the bone pain scores in the observation group and the control group were significantly lower than those before treatment (P<0.05), and the score in the observation group were also significantly lower than that in the control group (P<0.05). The serum TNF-ɑ content in the two groups after treatment were significantly lower than that before treatment (P<0.05), the observation group were significantly lower than that of control group (P<0.05). The adverse reactions in the two groups during treatment were more with fever, chills, bone marrow suppression and gastrointestinal reactions, there were no significant difference compared between the two groups. Conclusion The application of zoledronic acid combined with chemotherapy in NSCLC bone metastasis can improve the clinical efficacy and relieve pain, and does not increase the occurrence of adverse reactions. The mechanism of its action is related to the reduction of the expression of inflammatory factors.

R969.4