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免疫肠内营养对阿帕替尼治疗晚期胃癌患者的影响
常戈鋆
中国医科大学航空总医院肿瘤血液科, 北京 100012
Immune enteral nutrition on advanced gastrointestinal cancer patients undergoing apatinib
CHANG Ge-yun
Hematological Tumor Department, Aviation Gerneral Hospital/Beijing Institute of Translation Medicine, China Academy of Science, Beijing 100012, China
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摘要 目的 阿帕替尼是目前首个治疗晚期化疗耐药胃癌患者的有效口服抗肿瘤血管生成药物,该研究旨在探讨免疫肠内营养对晚期胃癌患者使用阿帕替尼治疗后营养状况及不良反应的影响。方法 选取我院2016年1月至2018年9月期间收治的108例晚期胃癌患者作为研究对象,采用随机数表法分为观察组(免疫肠内营养)和对照组(普通饮食指导)各54例,观察组给与免疫肠内营养剂(瑞能,华瑞制药公司,200ml/瓶)联合阿帕替尼,对照组给与普通饮食营养指导联合阿帕替尼,治疗前后进行营养和代谢指标、治疗不良反应、疗效以及院内感染率的观察,对观察数据进行统计及分析。结果 治疗前两组患者的年龄、性别、肿瘤类型、营养指标均无统计学差异(P>0.05)。经过两周期的阿帕替尼治疗后,观察组的PG-SGA、BMI、血清白蛋白、血清前白蛋白等营养指标均显著优于对照组,院内感染率显著低于对照组,其差异均有统计学意义(P<0.05)。2周期治疗后,观察组的BMI、ALB、PA较治疗前明显升高,而对照组的BMI、Hb、ALB、PA较治疗前均显著下降(P<0.05)。在阿帕替尼药物不良反应方面,观察组中乏力、骨髓抑制、腹泻等不良反应发生率均显著低于对照组(P<0.05),但两组患者的疗效无显著差异(P>0.05)。结论 抗血管生成治疗期间使用免疫增强型肠内营养可以显著改善晚期胃癌患者的营养状态,并有效减轻治疗相关消化道和骨髓抑制等不良反应,降低院内感染发生率。
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常戈鋆
关键词 免疫肠内营养晚期胃癌阿帕替尼    
Abstract:Objective Apatinib is currently the first effective oral anti-tumor angiogenesis drug for the treatment of patients with advanced chemotherapy-resistant gastric cancer. This study is to explore the effects of immune enteral nutrition treatment on the nutritional status and toxicity of advanced gastric cancer patients undergoing apatinib. Methods From January 2016 to September 2018,108 patients with gastric cancer selected from Aviation Gerneral Hospital were randomly divided into the treatment group and the control group. The observation group (n = 54) was treated with immune enteral nutritional support and apatinib, the control group (n = 54) was given normal diet direction and apatinib. Before and after 2 cycles, two groups were assessed and evaluated in terms of the nutritional status, toxicity reaction and nosocomial infection rate. Results Before treatment, the clinical data such as mean age, gender, types of cancer and nutritional index between the two groups were all no statistical significance (P>0.05). After treatment, the body mass index, albumin level and prealbumin level of observation group were all significantly better than those of the control group. The incidence of nosocomial infection in the observation group was significantly lower than in the control group (P<0.05). After two cycles of treatment, the body mass index, albumin level and prealbumin level of observation group were all higher than before (P<0.05). In contrast, the body mass index, hemoglobin, albumin and prealbumin level of control group were all lower than before (P<0.05).Regarding the adverse reactions of apatinib, the incidences of fatigue, myelosuppression and diarrhea were all significantly different(P<0.05). However, there was no statistical difference of efficiency between the two groups. Conclusions Providing enteral nutritional therapy to advanced gastric cancer patients undergoing antiangiogenic treatment can not only improve the nutrition status, but also alleviate the antiangiogenic-induced adverse reaction and the incidence of nosocomial infection.
Key words Immune enteral nutrition    Gastric cancer    Apatinib
    
通讯作者: 常戈鋆,电子邮箱:changgyfirst@126.com   
引用本文:   
常戈鋆. 免疫肠内营养对阿帕替尼治疗晚期胃癌患者的影响[J]. 肿瘤代谢与营养电子杂志, 2019, 6(2): 230-235.
CHANG Ge-yun. Immune enteral nutrition on advanced gastrointestinal cancer patients undergoing apatinib. Electron J Metab Nutr Cancer, 2019, 6(2): 230-235.