左卡尼汀对结直肠癌化疗营养状态及不良反应的影响  

Effects of levocarnitine on nutritional status and adverse reactions in colorectal cancer patients during adjuvant chemotherapy

作　　者：胡刚 杨建武 黄镇 周英豪 高然 杨鹤鸣 Hu Gang;Yang Jianwu;Huang Zhen;Zhou Yinghao;Gao Ran;Yang Heming(Department of General Surgery,Strategic Support Force Characteristic Medical Center,Beijing 100101,China)

机构地区：[1]战略支援部队特色医学中心普通外科,北京100101

出　　处：《肿瘤代谢与营养电子杂志》2020年第4期469-473,共5页Electronic Journal of Metabolism and Nutrition of Cancer

摘　　要：目的探讨左卡尼汀在结直肠癌患者辅助化疗期间对患者营养状态及不良反应的保护作用。方法将接受mFOLFOX 6方案化疗的结直肠癌术后患者随机分为试验组(加用左卡尼汀)及对照组,检测化疗前(T 0)、化疗4周期(T 1)及8周期(T 2)后患者营养指标,血液指标,评估骨髓抑制程度、胃肠道毒性以及外周神经毒性情况,并进行分析。结果T 0时两组患者的体质指数(BMI)及外周血中血红蛋白(Hb)、外周血淋巴细胞(PBL)、血清白蛋白(ALB)差异无统计学意义。T 1试验组患者的外周血Hb、PBL的含量高于对照组,差异有统计学意义(P<0.05),BMI和ALB的差异无统计学意义(P>0.05),而白细胞计数(WBC)、血小板(PLT)的差异无统计学意义,胃肠道毒性及外周神经毒性差异无统计学意义;T 2时试验组患者的外周血Hb、PBL、ALB的含量高于对照组,差异有统计学意义(P<0.05),外周血WBC的差异有统计学意义(P<0.05)。胃肠道毒性的差异有统计学意义(P<0.05),而BMI、外周血PLT的含量以及神经毒性的差异无统计学意义(P>0.05)。结论左卡尼汀在结直肠癌术后患者的辅助化疗期间能较好地维持患者的营养状态,缓解中性粒细胞的减少,且能减少患者的胃肠道毒性,有助于患者治疗的维持。Objective To investigate the protective effect of levocarnitine on nutritional status and adverse reactions in patients with colorectal cancer during adjuvant chemotherapy.Methods Patients with colorectal cancer who received mFOLFOX 6 chemotherapy in our department after surgery were randomly divided into the observation group(use levocarnitine)and the control group.Detection(T 0),4 cycles of chemotherapy before the chemotherapy(T 1)and 8 cycles(T 2)patients after nutrition index,index of blood,the evaluation of degree of bone marrow suppression and gastrointestinal toxicity and peripheral nerve toxicity,and analyzed.Results There was no significant difference in body mass index(BMI),peripheral blood hemoglobin(Hb),peripheral blood lymphocyte(PBL)and serum albumin(ALB)between the two groups at T 0.The content of Hb and PBL in peripheral blood of T 1 observation group was higher than that of control group,and the difference was statistically significant(P<0.05).The difference between BMI and ALB were not statistically significant(P>0.05).The difference between White blood cell(WBC)and platelet(PLT)was not statistically significant,and the gastrointestinal toxicity and peripheral neurotoxicity were not statistically significant.At T 2,the contents of Hb,PBL and ALB in peripheral blood of patients in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05),while the differences in WBC in peripheral blood were statistically significant(P<0.05).The differences in gastrointestinal toxicity were statistically significant(P<0.05),while the differences in BMI,peripheral blood PLT content and neurotoxicity were not statistically significant(P>0.05).Conclusion Levocarnitine can better maintain the nutritional status of patients,alleviate the reduction of neutrophils,and reduce the gastrointestinal toxicity of patients during adjuvant chemotherapy after colorectal cancer surgery,which is helpful for the maintenance of treatment.

关 键 词：左卡尼汀 结直肠癌 营养状态 胃肠道毒性 外周神经毒性 

分 类 号：R735.34[医药卫生—肿瘤]