术前骨骼肌质量减少对胃肠间质瘤病人术后伊马替尼治疗副作用的影响  

Effect of preoperative skeletal muscle mass reduction on side effects of postoperative adjuvant imatinib therapy in patients with gastrointestinal stromal tumors

作　　者：董千铜[1] 陈琛斌 陈伟哲[1] 张昭[3] 闫竞一[1] 陈笑雷[1] DONG Qian-tong;CHEN Chen-bin;CHEN Wei-zhe;ZHANG Zhao;YAN Jing-yi;CHEN Xiao-lei(Department of Gastrointestinal Surgery ,the First Affiliated hospital of Wenzhou Medical University;Department of Gastric Colon Surgery, the Second Affiliated hospital of Wenzhou Medical University;Department of Radiology ,the First Affiliated hospital of Wenzhou Medical University,Wenzhou 325000 ,Zhejiang, China)

机构地区：[1]温州医科大学附属第一医院胃肠外科 [2]温州医科大学附属第二医院胃结肠外科 [3]温州医科大学附属第一医院放射影像中心,325000

出　　处：《肠外与肠内营养》2019年第2期109-112,共4页Parenteral & Enteral Nutrition

基　　金：浙江省自然科学基金项目(LY15H160060);温州市科技局项目(Y20140364)

摘　　要：目的:探讨术前骨骼肌质量减少对中高危胃肠道间质瘤病人术后辅助伊马替尼治疗1年期间副作用的的影响。方法:回顾分析2008年至2017年我院中高危病人胃肠道间质瘤病人111例。根据术前L3SMI,分成肌肉质量减少组(S组,n=60例),无肌肉质量减少组(C组,n=51例),比较两组病人一般资料,术前1月至服药后3月、6月和1年的血白蛋白,肌酐和CT第3腰椎骨骼肌指数的变化以及伊马替尼药物副作用。结果:S组术前和术后3月血白蛋白水平较C组低,(P <0.05);两组血肌酐组间比较差异无统计学意义(P> 0.05),但两组术前较本组术后3月,术后6月和术后12月偏低(P <0.01);S组第3腰椎骨骼肌指数在术前及术后均较C组偏低(P <0.05)。同时,S组水肿,疲乏,腹泻和血红蛋白减少的发生比例较C组高(P <0.05)。结论:合并肌肉质量减少的中高危胃肠道间质瘤病人伊马替尼的药物毒副反应更加明显,术后辅助治疗期间第3腰椎骨骼肌指数恢复更加缓慢。Objective: To investigate the effect of preoperative skeletal muscle mass reduction on the side effects from imatinib during one year adjuvant therapy in postoperative patients with high-risk gastrointestinal stromal tumors.Methods: To retrospectively analyze of 111 high-risk patients with gastrointestinal stromal tumors from 2008 to 2017. 60 patients with preoperative muscle mass loss were assigned to group S, and the others were assigned to group C. The general information, the changes in serum albumin, creatinine and the 3 rd lumbar vertebra skeletal muscle index on CT and side effects of imatinib were compared between the two groups on 1 month before surgery, 3 months, 6 months and 1 year after administration. The adverse drug reactions of imatinib were also recorded. Results: The levels of blood albumin in the group S were significantly lower than group C on 1 month before surgery and 3 months after administration(P < 0.05). There was no difference between two groups on blood creatinine(P > 0.05). Compared to preoperation, blood creatinine levels were higher after surgery in both groups(P < 0.01). Both before and after surgery, the3 rd lumbar vertebra skeletal muscle index of in group S was lower than that in group C(P < 0.01). The incidence of edema, fatigue, diarrhea and anemia in group S was significantly higher than that in group C(P<0.05). Conclusions:The drug side effects of imatinib were more obvious in patients with medium-high risk gastrointestinal stromal tumor complicated with muscle mass loss. L3 SMI in patients with muscle mass loss recovery slowly during one year of adjuvant treatment with imatinib.

关 键 词：胃肠道间质瘤 伊马替尼 肌肉质量减少 

分 类 号：R459.3[医药卫生—治疗学]