許震 左云 盧瑋冬

[摘要] 目的 研究貝伐珠單抗聯(lián)合紫杉醇脂質(zhì)體+替吉奧治療中晚期胃癌的臨床效果。 方法 選擇2012年4月～2017年12月于江蘇省張家港市第一人民醫(yī)院腫瘤科接受治療的90例中晚期胃癌患者，按照不同治療方式分成研究組和對(duì)照組，每組45例。對(duì)照組予以紫杉醇脂質(zhì)體聯(lián)合替吉奧治療，研究組在對(duì)照組的基礎(chǔ)上加用貝伐珠單抗治療。比較兩組臨床療效，血清糖類抗原724（CA724）、血清糖類抗原199（CA199）水平，不良反應(yīng)發(fā)生情況，生活質(zhì)量以及免疫功能。 結(jié)果 研究組總有效率（88.89%）高于對(duì)照組（68.89%），差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）。兩組治療后CA724、CA199水平顯著低于治療前，差異均有高度統(tǒng)計(jì)學(xué)意義（均P < 0.01）。研究組血清CA724、CA199水平較對(duì)照組顯著降低，差異均有高度統(tǒng)計(jì)學(xué)意義（均P < 0.01）。兩組白細(xì)胞減少、惡心嘔吐、肝腎功能異常以及脫發(fā)的發(fā)生率比較，差異均無(wú)統(tǒng)計(jì)學(xué)意義（均P > 0.05）。治療后研究組卡氏功能狀態(tài)評(píng)分顯著高于對(duì)照組，差異有高度統(tǒng)計(jì)學(xué)意義（P < 0.01）。研究組CD4+、CD4+/CD8+水平較對(duì)照組顯著升高，差異有統(tǒng)計(jì)學(xué)意義（P < 0.05或P < 0.01）。 結(jié)論 貝伐珠單抗聯(lián)合紫杉醇脂質(zhì)體+替吉奧治療中晚期胃癌的臨床效果顯著，值得推廣應(yīng)用。

[關(guān)鍵詞] 胃癌;貝伐珠單抗;紫杉醇脂質(zhì)體;替吉奧;臨床效果

[中圖分類號(hào)] R735.2? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 1673-7210（2019）08（b）-0106-05

[Abstract] Objective To study the clinical effect of Bevacizumab combined with Paclitaxel Liposome and Tegafur Gimeracil and Oteracil Potassium in the treatment of medium and advanced gastric cancer. Methods Ninety patients with medium and advanced gastric cancer who were treated in the Oncology Department of Zhangjiagang First People′s Hospital from April 2012 to December 2017 were selected and divided into study group and control group according to different treatment methods， with 45 cases in each group. The control group was treated with Paclitaxel Liposome combined with Tegafur Gimeracil and Oteracil Potassium， while the study group was treated with Bevacizumab on the basis of the control group. The clinical efficacy， serum carbohydrate antigen 724 （CA724）， carbohydrate antigen 199 （CA199） levels， adverse reactions， quality of life and immune function were compared between the two groups. Results The total effective rate of the study group （88.89%） was higher than that of the control group （68.89%）， and the difference was statistically significant （P < 0.05）. The levels of CA724 and CA199 in the two groups after treatment were significantly lower than before treatment， and the differences were all highly statistically significant （all P < 0.01）. The levels of serum CA724 and CA199 in the study group were all significantly lower than those in the control group， and the differences were all highly statistically significant （all P < 0.01）. There were no significant differences in the incidence of leukopenia， nausea and vomiting， abnormal renal and liver function and alopecia between the two groups （all P > 0.05）. The Karnofsky performance score of the study group was significantly higher than that of the control group after treatment， and the difference was highly statistically significant （P < 0.01）. The levels of CD4+ and CD4+/CD8+ in the study group were significantly higher than those in the control group， and the differences were statistically significant （P < 0.05 or P < 0.01）. Conclusion Bevacizumab combined with Paclitaxel Liposome and Tegafur Gimeracil and Oteracil Potassium is effective in the treatment of medium and advanced gastric cancer. It is worth popularizing and applying.