结直肠癌患者伊立替康化疗相关迟发性腹泻的发生情况及影响因素分析  

Analysis of Occurrence and Influencing Factors of Irinotecan-Related Delayed-Onset Diarrhea in Patients with Colorectal Cancer

作　　者：李丽 刘倩 LI Li;LIU Qian(Department of Oncology,Huaian Fifth People's Hospital,Huaian,Jiangsu 223000)

机构地区：[1]淮安市第五人民医院肿瘤科,江苏淮安223000

出　　处：《中国肛肠病杂志》2025年第2期51-53,共3页Chinese Journal of Coloproctology

摘　　要：目的:调查接受含伊立替康方案化疗的结直肠癌患者,统计伊立替康用药后迟发性腹泻的发生情况,并分析其影响因素。方法:选择2022年1月至2024年6月于我科接受FOLFIRI方案[5-氟尿嘧啶(5-FU)+伊立替康(CPT-11)+亚叶酸钙(CF)]化疗的116例结直肠癌患者作为研究对象,以是否发生迟发性腹泻分组,即迟发性腹泻组和未发生迟发性腹泻组(简称对照组),通过单因素和Logistic回归分析法分析影响迟发性腹泻发生的危险因素。结果:116例患者中发生迟发性腹泻50例(43.10%),其中Ⅰ级腹泻6例,Ⅱ级腹泻17例,Ⅲ级腹泻22例,Ⅳ级腹泻5例。迟发性腹泻组≥65岁患者比例高于对照组,UGT1A1^(*)6、UGT1A1^(*)28基因型杂合突变型患者构成比高于对照组,P<0.05;迟发性腹泻组与对照组在患者性别、KPS评分、放疗史、化疗前总胆红素(TBIL)和血红蛋白(Hb)水平方面差异均无统计学意义,P>0.05。Logistic回归分析显示,年龄≥65岁、UGT1A1^(*)6杂合突变型、UGT1A1^(*)28杂合突变型是结直肠癌患者发生迟发性腹泻的危险因素(OR值分别为1.486,1.892,1.383;95%CI分别为1.029~2.083,1.227~2.806,1.106~1.851)。结论:年龄≥65岁、UGT1A1^(*)6和UGT1A1^(*)28基因杂合突变的结直肠癌患者使用含伊立替康的方案化疗后迟发性腹泻的发生风险高,临床应予以关注,有效防治。Objective To investigate the occurrence of delayed-onset diarrhea after irinotecan-based chemotherapy in patients with colorectal cancer,and to analyze its influencing factors.MethodsA total of 116 patients with colorectal cancer who received FOLFIRI regimen[5-fluorouracil(5-FU)+irinotecan(CPT-11)+calcium folinate(CF)] chemotherapy in our department from January 2022 to June 2024 were selected as the research objects.The risk factors affecting the occurrence of delayed-onset diarrhea were analyzed by univariate and Logistic regression analysis.Results Among the 116 patients,50(43.10%)had delayed-onset diarrhea,including 6 cases of grade I diarrhea,17 cases of grade II diarrhea,22 cases of grade II diarrhea and 5 cases of grade IV diarrhea.Compared with the control group,the delayed-onset diarrhea group had a significantly higher proportion of patients aged≥65 years,and a significantly higher proportion of patients with heterozygous mutations in UGT1A1^(*)6 and UGT1A1^(*)28 genotypes(P<0.05).There was no significant difference in gender,KPS score,radiotherapy history,levels of total bilirubin(TBIL)and hemoglobin(Hb)before chemotherapy between the delayed-onset diarrhea group and the control group(P>0.05).Logistic regression analysis showed that age≥65 years,heterozygous mutations in UGT1A1^(*)6 and UGT1A1^(*)28 genotypes were risk factors for delayed-onset diarrhea in patients with colorectal cancer(OR:1.486,1.892,1.383;95%CI:1.029-2.083,1.227-2.806,1.106-1.851).Conclusion Patients with colorectal cancer aged≥65 years with heterozygous mutations in UGT1A1^(*)6 and UGT1A1^(*)28 genotypes have a high risk of delayed-onset diarrhea after irinotecan-based chemotherapy,which should be concerned clinically for effective prevention and treatment.

关 键 词：结直肠癌 伊立替康 迟发性腹泻 影响因素 

分 类 号：R735.3[医药卫生—肿瘤]