摘要
目的探究雷替曲塞腹腔灌注对接受根治性切除术的结直肠癌患者血清甲胎蛋白(AFP)、糖类抗原72-4(CA72-4)水平和不良反应的影响。方法选取2021年4月至2024年4月于武汉大学中南医院接受根治性切除术的结直肠癌患者110例为研究对象,根据治疗方案分为研究组与对照组,各55例。两组均予以根治性切除术,研究组患者在腹部闭合前接受雷替曲塞腹腔灌注。比较两组血清AFP和CA72-4水平、血常规指标[白细胞计数(WBC)、血小板计数(PLT)、血红蛋白(Hb)]水平、肝肾功能指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、尿素氮(BUN)、血肌酐(Scr)]水平及消化道不良反应、术后并发症情况。结果手术后两组患者的血清AFP、CA72-4水平随时间的增加而降低(P<0.05);研究组术后3、7 d的血清AFP、CA72-4水平[分别为(4.73±1.32)μg·L^(-1)、(8.61±1.36)U·mL^(-1),(3.18±1.48)μg·L^(-1)、(6.73±1.26)U·mL^(-1)]低于对照组[分别为(5.41±1.81)μg·L^(-1)、(9.15±1.31)U·mL^(-1),(3.87±1.39)μg·L^(-1)、(7.22±0.75)U·mL^(-1)](t_(术后3 d)=2.251、2.121,t_(术后7 d)=2.520、2.478,均P<0.05)。手术后两组患者的WBC、PLT水平随时间的增加而降低(P<0.05),且术后7 d研究组患者PLT水平低于对照组(P<0.05),其余组间差异无统计学意义(P>0.05)。手术前后两组患者Hb水平差异无统计学意义(P>0.05);手术前后两组患者ALT、AST、BUN、Scr水平差异无统计学意义(P>0.05)。术后两组患者消化道不良反应、术后并发症发生情况比较,差异无统计学意义[9.10%(5/55)vs 3.64%(2/55),3.64%(2/55)vs 7.28%(4/55),χ^(2)=0.610、0.176,均P>0.05]。结论雷替曲塞腹腔灌注可有效降低接受根治性切除术的结直肠癌患者血清AFP、CA72-4水平,且具有较高耐受性和安全性。
Objective To investigate the effect of intraperitoneal perfusion of raltitrexed on serum alpha-fetoprotein(AFP),cancer antigen 72-4(CA72-4)levels,and adverse reactions in patients undergoing radical resection of colorectal cancer.Methods A total of 110 colorectal cancer patients undergoing radical resection in Zhongnan Hospital of Wuhan University from April 2021 to April 2024 were enrolled and divided into a study group(n=55)and a control group(n=55).All the patients in both groups received radical resection,while those in the study group additionally received intraperitoneal perfusion of raltitrexed before abdominal closure.Serum AFP,CA72-4,blood routine parameters(white blood cell(WBC),platelet(PLT),hemoglobin(Hb)),liver and kidney function indices(alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN),serum creatinine(Scr)),gastrointestinal adverse reactions,and postoperative complications were compared between the two groups.Results Postoperatively,the serum AFP and CA72-4 levels decreased over time in both groups(P<0.05).The serum levels of AFP and CA72-4 in the study group on the 3rd and 7th days after surgery((4.73±1.32)μg·L^(-1),(8.61±1.36)U·mL^(-1),(3.18±1.48)μg·L^(-1) and(6.73±1.26)U·mL^(-1))were lower than those in the control group((5.41±1.81)μg·L^(-1),(9.15±1.31)U·mL^(-1),(3.87±1.39)μg·L^(-1),(7.22±0.75)U·mL^(-1))(_(t3 days after surgery)=2.251,2.121,t_(7 days after surgery)=2.520,2.478,all P<0.05).Postoperatively,WBC and PLT levels decreased over time in both groups(P<0.05);at postoperative day 7,the PLT level in the study group was significantly lower than in the control group(all P<0.05);other group comparisons were statistically non-significant(P>0.05).No significant differences were found in Hb levels before and after surgery(P>0.05).Similarly,ALT,AST,BUN,and Scr levels showed no significant intergroup or temporal differences(P>0.05).The incidence of gastrointestinal adverse reactions(9.10%(5/55)vs 3.64%(2/55))and postoperative complications(3.64%(2/55)vs 7.28%(4/55))did not differ significantly between the study group and the control group(χ^(2)=0.610,0.176,both P>0.05).Conclusion Intraperitoneal perfusion of raltitrexed effectively reduces serum AFP and CA72-4 levels in colorectal cancer patients undergoing radical resection,and it has high tolerance and safety.
作者
骆曼
郑新怡
朱华羚
Luo Man;Zheng Xinyi;Zhu Hualing(Department of Colorectal and Anal Surgery,Zhongnan Hospital of Wuhan University,Wuhan 430000,China)
出处
《中国药物应用与监测》
2025年第5期801-805,共5页
Chinese Journal of Drug Application and Monitoring
关键词
雷替曲塞
结直肠癌根治术
腹腔灌注化疗
甲胎蛋白
糖类抗原72-4
不良反应
Raltitrexed
Radical resection of colorectal cancer
Intraperitoneal perfusion chemotherapy
Alpha-fetoprotein
Cancer antigen 72-4
Adverse reaction
