胃复春对不同NLR水平的胃早癌ESD术后患者的消化道症状、胃肠激素、胃功能指标和血常规指标的影响  

Effects of Weifuchun on gastrointestinal symptoms,gastrointestinal hormones,gastric function indexes,and routine blood indexes in early gastric cancer patients with different preoperative neutrophil-to-lymphocyte ratio levels after endoscopic submucosal dissection

作　　者：许冬佳 翟浩亮 沈宏[1] 孙威 Dong-Jia Xu;Hao-Liang Zhai;Hong Shen;Wei Sun(Department of Gastroenterology,Haining People’s Hospital,Haining 314400,Zhejiang Province,China)

机构地区：[1]海宁市人民医院消化内科,浙江省海宁市314400

出　　处：《世界华人消化杂志》2024年第5期347-354,共8页World Chinese Journal of Digestology

摘　　要：背景胃复春可治疗内镜下剥离术(endoscopic submucosal dissection,ESD)后的胃早癌患者,中性粒细胞-淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)可作为评估此类患者活动度和预后的指标.目前尚未确定不同NLR水平的ESD术后胃早癌患者是否存在与之相关的胃复春疗效差异.目的探讨胃复春对不同NLR水平的胃早癌ESD术后患者的治疗效果.方法选取本院2020-01/2022-12收治的160例胃早癌ESD术后患者,将其分为常规治疗组(n=40)和常规治疗+胃复春治疗组(n=120).将胃复春治疗组再按照NLR水平进行三分位分组,分为高三分位组(NLR≥3.23)40例,低三分位组(NLR≤1.74)40例,中三分位组(NLR:1.74-3.23)40例.比较以上各组治疗前后的主要的消化道症状评分、胃肠激素水平、胃功能指标及血常规指标水平,并计算治疗的总有效率.结果与治疗前比较,治疗后各组患者的胃脘灼热、胃脘胀满、胃脘疼痛和胃纳呆滞评分均降低(P<0.05),其中以低三分位组治疗效果最佳(P<0.05),总有效率最高(P<0.05).常规治疗不能改变患者NLR与血小板-淋巴细胞比值(platelet to lymphocyte ratio,PLR)水平,而常规治疗+胃复春治疗能降低患者的NLR与PLR水平(P<0.05).治疗后,与常规治疗组比较,胃复春治疗组(低、中和高三分位组)的抑胃肽、胃动素、胃泌素、胃蛋白酶原Ⅰ和胃蛋白酶原比值水平均增高(P<0.05)、白细胞、胃蛋白酶原Ⅱ和癌胚抗原均降低(P<0.05),其中以低三分位组最为明显.结论胃复春在不同NLR水平的胃早癌ESD术后患者中均显示出改善消化道症状、胃肠激素、胃功能指标和血常规指标的作用,尤其对于低NLR水平患者而言,治疗效果最为显著.在选择治疗方法时,建议优先考虑低NLR水平的胃早癌ESD术后患者使用胃复春进行治疗.BACKGROUND Weifuchun is a viable treatment option for patients with early gastric cancer following endoscopic submucosal dissection(ESD).Neutrophil-to-lymphocyte ratio(NLR)can serve as an indicator for evaluating the activity and prognosis of such patients.However,it remains unclear whether there exists a difference in the efficacy of Weifuchun among patients with early gastric cancer after ESD who have varying preoperative NLR levels.AIM To investigate the therapeutic effects of Weifuchun on patients with early gastric cancer with different preoperative NLR levels after ESD.METHODS A total of 160 patients with early gastric cancer after ESD admitted to our hospital from January 2020 to December 2022 were selected,and they were divided into either a conventional treatment group(n=40)or a conventional treatment+Weifuchun treatment group(n=120).The Weifuchun treatment group was stratified into three tertile groups based on preoperative NLR level:High tertile group(NLR≥3.23,n=40),low tertile group(NLR≤1.74,n=40),and medium tertile group(NLR:1.74-3.23,n=40).Main gastrointestinal symptoms,gastrointestinal hormones,gastric function indexes,and routine blood indexes were compared before and after treatment,followed by calculation of the total effective rate.RESULTS The scores of epigastric burning,fullness,epigastric pain,and stomach dullness were significantly reduced in all groups after treatment compared to those before treatment(P<0.05).Notably,the low tertile group exhibited the most favorable treatment effect(P<0.05),resulting in the highest total effective rate(P<0.05).The levels of NLR and platelet-to-lymphocyte ratio(PLR)remained unchanged with conventional treatment alone,whereas the combination of conventional treatment and Weifuchun treatment significantly reduced the levels of NLR and PLR(P<0.05).After the treatment,compared to the conventional treatment group,the Weifuchun treatment group(low,medium,and high tertiles)exhibited a significant increase in gastric inhibitory peptide,motilin,gastrin,pepsino

关 键 词：胃早癌 内镜粘膜下剥离术 胃复春 中性粒细胞-淋巴细胞比值 消化道症状 胃肠激素 胃功能 

分 类 号：R735.2[医药卫生—肿瘤]