肿瘤化疗对血清胃动素和胃液素的影响

Serum levels of motilin and gastrin in leukemia patients with chemotherapy

目的探讨白血病化疗对血清胃动素和胃液素的影响。方法急慢性白血病患者9例,男7例,女2例,年龄34.1±17.3岁(5-51岁)。其中ALL(急性淋巴细胞白血病)2例(男女各1例),AML(急性粒细胞白血病)-M_5 3例(均为男性),AML-M_4 1例(男性)和MDSCMML(骨髓增生异常综合征-慢性白血病型)2例(男女各1例)。全部患者均经周围细胞学和骨髓细胞学确诊。选择健康人26例(男12例,女14例)作为对照。化疗方案:ALL用VDP方案(VCR 1,7,14,21 d,DNR 1-3 d,Pred 1-28 d),AML-M_(4-5)用DA方案(DNR 1-3 d,Ara-C 1-7d)。MDS-CMML用Ara-C(1-10d)加维甲酸(1-28d)。静脉化疗前用甲氧氯普胺10-20 mg静注。全部患者均于化疗前、化疗后3,7,14和28d晨空腹卧位取肘静脉血标本2 ml,血清胃动素和胃液素用放射免疫法测定。结果与正常对照比较,白血病患者化疗前血清胃动素和胃液素轻度升高(P>0.05),化疗后3 d,胃动素和胃液素升高,7 d达最高(P<0.01),14 d开始下降(胃动素仍明显高于正常,P<0.05),于化疗后28d恢复至化疗前水平。化疗后3d曲清胃动素和胃液素r=0.462,P<0.05;7 d r=0.458,P<0.05,呈正相关。结论白血病患者化疗后血清胃动素和胃液素明显升高,这一发现对研究发生于化疗后之恶心呕吐的防治和抗化疗性恶心呕吐药物可能有一定意义。

AIMS To determine the effect of chemotherapy on the gastrointestinal hormones, serum levels of motilin and gastrin were measured in patients treated with chemotherapy. METHODS A total of 9 leukemia patients treated with chemotherapy have been enrolled in the study, including ALL(n=2), AML-Ms(n=3), AML-M4 (n=1) and MDS-CMML(n=2). Patients received a VDP regimen (VCR on 1, 7, 14 and day 21, DNR on day 1-3, and Pred on day 1-28) for ALL, a DA regimen (DNR on day 1-3, Ara-C on day 1-7) for AML-M_(4.5), and with Ara-C(on day 1-10) and RAR (on day 1-28) for MDS-CMML. Blood samples of 2 ml were collected in dry tubes in fasting condition in pretreatment and on day 3, 7, 14 and 28 after/during chemotherapy. Serum motilin and gastrin were measured by radioimmunoassay kit. RESULTS In pretreatment patients, serum motlin (224.16±5:131.57 vs 207.32±98.45 ng/L) and gastrin (62.46±25.60 vs 56.92±21.47 ng/L) had no difference than that in normal subjects. In posttreatmerit patients, motilin and gastrin on day 3 (786.66±234.52 and 96.21±39.07, P<0.01, respectively), on day 7 (810.49±281.91and 98.18±44.3, P<0.01, respectively) and day 14 (357.82± 126.39 P<0.05 for motilin) were bighter than those in the normal subjects. The serum motilin level correleted with the gastrin on day 3 (r=0.462, P<0.05) and day 7 (r=0.458, P<0.05). CONCLUSIONS Serum values of motilin and gastrin are increased in leukemia patients received chemotherapy, and is of a clinical significance to prevent nausea/vomiting in chemotherapy.