不同剂量维生素D3对进展期胃癌术后无进展生存期和营养状态的影响  

Effects of different doses of vitamin D3 on progression-free survival and nutritional status after advanced gastric cancer surgery

作　　者：刘林辉[1] 李云霞[1] 朱凤霞[1] 董明香 袁林玉 LIU Lin-hui;LI Yun-xia;ZHU Feng-xia;DONG Ming-xiang;YUAN Lin-yu(Department of Oncology and Hematology,Tang County People's Hospital of Hebei Province,Baoding 072350,China)

机构地区：[1]河北省唐县人民医院肿瘤血液科,河北保定072350

出　　处：《中国现代普通外科进展》2021年第1期34-39,共6页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:评估接受高剂量和标准剂量维生素D3对进展期胃患者术后无进展生存期(PFS)和营养状态的影响。方法:2017年1月—2018年3月,进展期胃癌术后患者78例。根据维生素剂量不同随机分为高剂量组(4000 IU/d)和标准剂量组(400 IU/d)。分别记录患者术前、术后6个月、12个月、24个月的25(OH)D、血红蛋白、白蛋白、血钙水平以及PG-SGA和NRS-2002评分。记录患者的中位生存时间(OS)和PFS,运用Kaplan-Meier绘制生存曲线。结果:高剂量组和标准剂量组的术后复发率OS和PFS差异无统计学意义(均P>0.05)。术后6、12、24个月25(OH)D水平高剂量组均显著高于标准剂量组,PG-SGA评分、NRS-2002评分高剂量组均显著低于标准剂量组(均P<0.05)。两组25(OH)D水平术后6个月均显著高于术前,术后12个月均显著高于术后6个月(P<0.05)。PG-SGA评分,NRS-2002评分术后24个月显著低于术后6个月和12个月(P<0.05)。高剂量组发生腹泻的比例低于标准剂量组(P<0.05)。结论:给予高剂量维生素和标准剂量维生素不能改善进展期胃癌术后的中位生存期和中位无进展生存期,但高剂量组患者术后的25(OH)D水平和营养状态明显改善。Objective:To evaluate the effect of receiving high-dose and standard-dose vitamin D3 on postoperative progression-free survival(PFS)and nutritional status of patients with progressive stomach.Methods:78 patients with advanced gastric cancer who were admitted to our hospital from January 2017 to March 2018 were selected.According to the double-blind and random principle,they were randomly divided into high-dose group(4000 IU/d)and standard-dose group(400 IU/d)according to different vitamin doses.The 25(OH)D,hemoglobin,albumin,blood calcium levels,PG-SGA and NRS-2002 scores were recorded at pre-operation and 6 months,12 months and 24 months after operation.The patients'median OS and PFS were recorded,Using Kaplan-Meier to draw survival curve.Results:There was no significant difference in postoperative recurrence rate,median OS and PFS between the high-dose group and the standard-dose group(both P>0.05).At 6,12,and 24 months after surgery,25(OH)D levels were significantly higher in the high-dose group than in the standard-dose group,and the PG-SGA score and NRS-2002 score were significantly lower in the high-dose group than in the standard-dose group(All P<0.05).Comparison within the group showed that the 25(OH)D level of the two groups was significantly higher than that before the operation at 6 months,and significantly higher than the 6 months after the operation at 12 months(P<0.05).And PG-SGA score,NRS-2002 score at 24 months after surgery was significantly lower than 6 and 12 months after surgery(P<0.05).In addition,the proportion of diarrhea in the high-dose group was lower than that in the standard-dose group(P<0.05).Conclusion:Compared with standard-dose vitamins,high-dose vitamins do not improve the median survival and median progression-free survival after advanced gastric cancer surgery,but the 25(OH)D level and nutritional status of patients in the high-dose group after surgery Significant improvement.

关 键 词：维生素D3 生存分析 25(OH)D 进展期胃癌 营养状态 

分 类 号：R735.3[医药卫生—肿瘤]