二甲双胍联合阿帕替尼治疗中晚期胃癌患者的疗效及对肠道菌群的影响  

Curative efficacy of metformin in combination with apatini in treating patients with medium and advanced gastric cancer and its influences on intestinal flora

作　　者：刘跃辉[1] 郑春红[1] 李倩[1] 魏成明[2] LIU Yuehui;ZHENG Chunhong;LI Qian;WEI Chengming(Department of Pharmacy,Zigong First People′s Hospital,Sichuan Province,Zigong 643000,China;Department of Oncology,Zigong First People′s Hospital,Sichuan Province,Zigong 643000,China)

机构地区：[1]四川省自贡市第一人民医院药剂科,643000 [2]四川省自贡市第一人民医院肿瘤科,643000

出　　处：《国际消化病杂志》2020年第1期36-40,共5页International Journal of Digestive Diseases

摘　　要：目的探讨二甲双胍联合阿帕替尼治疗中晚期胃癌患者的疗效及对肠道菌群的影响。方法收集122例中晚期胃癌患者作为观察对象,回顾性分析其临床资料,按照治疗方案的不同,分为对照组(58例)和观察组(64例)。所有患者均给予紫杉醇+顺铂+5-氟尿嘧啶进行化学治疗。在此基础上,对照组给予阿帕替尼治疗,观察组给予二甲双胍联合阿帕替尼治疗。治疗后,比较对照组和观察组患者的短期疗效、血清肿瘤标志物水平、不良反应及肠道菌群含量。结果疗效评价显示,对照组和观察组患者短期治疗的总有效率差异无统计学意义(63.8%比75.0%,P>0.05)。治疗后,与对照组相比,观察组患者血清糖链抗原19-9(CA19-9)、CA242和癌胚抗原(CEA)表达水平降低,差异均有统计学意义(P均<0.05)。治疗期间,观察组患者Ⅰ~Ⅱ度胃肠道反应的发生率较对照组升高(P<0.05),而蛋白尿、高血压、白细胞减少、出血、手足皮肤反应及Ⅲ~Ⅳ度胃肠道反应发生率组间比较显示,差异均无统计学意义(P均>0.05)。治疗后,与对照组相比,观察组患者双歧杆菌、乳酸杆菌含量增加,肠球菌、大肠杆菌含量减少,组间比较差异均有统计学意义(P均<0.05)。结论二甲双胍联合阿帕替尼治疗中晚期胃癌的疗效良好,短期治疗有效率较高,能够有效降低血清肿瘤标志物水平,调节肠道菌群,且仅导致Ⅰ~Ⅱ度胃肠道反应的发生率升高。Objective An effort was made in this paper to investigate the curative efficacy of metformin in combination with apatini in treating patients with medium and advanced gastric cancer and its influences on intestinal flora.Methods One hundred and twenty-two patients with medium and advanced gastric cancer were selected and divided into the control group(n=58)and the observation group(n=64)according to therapeutic schemes to retrospectively analyze their clinical materials.All patients were treated with chemotherapy regimen(paclitaxel+cisplatin+5-fluorouracil).Besides,the observation group was treated with apatini,while the observational group was treated with metformin in combination with apatini.After treatment,the short-term curative efficacy,serum tumor markers,toxic side effects,and content of intestinal flora of the two groups were compared.Results The efficacy evaluation showed that there was no significant difference in the total effective rate of short-term treatment between the two groups(63.8%vs.75.0%,P 0.05).After treatment,in comparison with the control group,the observation group had lower serum tumors markers of CA19-9,CA242,and CEA with statistical differences(all P<0.05).During the treatment,the observation group had a statistically higher incidence of gastrointestinal reaction of degreeⅠ-Ⅱ(P<0.05),while incidences of toxic side effects of proteinuria,hypertension,leucopenia,bleeding,hand-foot skin reaction and gastrointestinal reaction of degreeⅢ-Ⅳin the two groups were statistically the same(all P 0.05).After treatment,in comparison with the control group,the content of bifidobacteria and lactobacilli increased and the content of Enterococcus and Escherichia coli decreased in the observation group with statistical differences(all P<0.05).Conclusion Metformin in combination with apatini has a good curative efficacy in patients with medium and advanced gastric cancer with a high total short-term curative efficacy ratio,which can effectively reduce serum tumor markers and regulate intestinal

关 键 词：二甲双胍 阿帕替尼 中晚期胃癌 糖链抗原19-9 糖链抗原242 癌胚抗原 胃肠道反应 肠道菌群 

分 类 号：R735.2[医药卫生—肿瘤]