阿帕替尼联合化疗对晚期肺癌患者营养状态和应激反应的影响研究  

Study on the effects of apatinib combined with chemotherapy on nutritional status and stress response in patients with advanced lung cancer

作　　者：姚国丽 孙宁 苏钰 施雪霏 YAO Guoli;SUN Ning;SU Yu;SHI Xuefei(Department of Respiratory Medicine and Intensive Care Unit,Huzhou Central Hospital,Affiliated Central Hospital of Huzhou University,Huzhou313000,China)

机构地区：[1]湖州市中心医院湖州师范学院附属中心医院呼吸与危重症医学科,浙江湖州313000

出　　处：《中国现代医生》2022年第15期76-79,143,共5页China Modern Doctor

基　　金：国家自然科学基金项目(81602003)。

摘　　要：目的 探讨阿帕替尼联合化疗在晚期肺癌患者中的临床效果及对营养状态和应激反应的影响。方法 选择2017年4月至2018年1月湖州市中心医院收治的晚期肺癌患者78例,随机数字表法分为化疗组和联合组,各39例。化疗组采用一线化疗方案治疗,联合组在化疗组基础上联合阿帕替尼治疗,3个化疗周期后评价的效果并对患者进行3年随访,比较两组的营养状态、应激反应、毒副反应发生率及生存率。结果 两组治疗3个化疗周期后的营养状态均得到明显改善;联合组的TP、ALB、Hb、PA及TLC水平均高于化疗组,差异有统计学意义(P<0.05);两组治疗3个化疗周期后的MDA、AOPP水平均低于用药前,差异有统计学意义(P<0.05);SOD、GSH-Px水平高于用药前,差异有统计学意义(P<0.05);联合组干预3个化疗周期后的MDA、AOPP低于化疗组(P<0.05);SOD、GSH-Px高于化疗组,差异有统计学意义(P<0.05);两组用药期间的白细胞减少、皮肤反应、出血发生率比较,差异无统计学意义(P>0.05);联合组疗程后1、2、3年的生存率均高于化疗组(P<0.05)。结论 阿帕替尼联合化疗治疗晚期肺癌能获得良好效果,可提升患者的营养状态,有助于降低患者的应激反应,且药物安全性较高,可获得较高的远期生存率,值得推广应用。Objective To investigate the clinical efficacy of apatinib combined with chemotherapy in patients with advanced lung cancer and the effects on nutritional status and stress response. Methods A total of 78 patients with advanced lung cancer from April 2017 to January 2018 admitted to Huzhou Central Hospital were selected as subjects and divided into two groups with 39 cases each by random number table method. The chemotherapy group was treated with first-line chemotherapy regimen, while the combined group was treated with apatinib on the basis of the treatment in the Chemolhercpy group. The efficacy and effects on patients were evaluated after 3 chemotherapy cycles, and the patients were followed up for 3 years. The nutritional status, stress response, incidence of toxic side effects and survival rate were compared between the two groups. Results The nutritional status of both groups improved significantly after 3cycles of chemotherapy, and the levels of indicators for nutritional status such as total protein(TP), albumin(ALB),hemoglobin(Hb), prealbumin(PA) and total lymphocyte count(TLC) in the combined group were higher than those in the chemotherapy group after 3 cycles of chemotherapy, with statistically significant differences(P<0.05). The levels of malondialdehyde(MDA) and advanced oxidation protein product(AOPP) were lower, and superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px) were higher in both groups after 3 cycles of chemotherapy than before drug administration, with statistically significant differences(P<0.05). The levels of MDA and AOPP were lower, and SOD and GSH-Px were higher in the combined group than those in the chemotherapy group after 3 chemotherapy cycles of intervention, with statistically significant differences(P<0.05). There were no statistically significant differences between the two groups in the incidences of leukopenia, skin reaction, and bleeding during drug administration(P>0.05). The survival rates at 1, 2 and 3 years after 3 cycles of chemotherapy were higher in the co

关 键 词：阿帕替尼 化疗 晚期肺癌 营养状态 应激反应 

分 类 号：R734.2[医药卫生—肿瘤]