内源性二氢尿嘧啶与尿嘧啶比值在5-Fu化疗中毒性关系的临床研究

Clinical Study of Endogenous Uracil Derivatives Ratio in 5-Fu Chemotherapy Toxicity

目的评价内源性二氢尿嘧啶(UH2)与尿嘧啶(U)比值在5-Fu化疗中消化系统毒性的关系,为5-Fu在恶性肿瘤中的个体化治疗提供一种理论依据。方法70例恶性肿瘤患者,大肠癌48例,鼻咽癌21例,食管癌1例,化疗前采用高效液相色谱法测定UH2与U的值,比值≥2.05为正常。结果UH2/U值正常者53例,发生Ⅰ～Ⅱ度恶心呕吐、腹泻和口腔粘膜炎分别为35、26和17例;UH2/U值<2.05者17例,各有7例患者出现Ⅰ～Ⅱ度恶心呕吐和腹泻,9例患者出现口腔粘膜炎,发生Ⅲ～Ⅳ度反应分别为9、9、7例,两者间有显著性差异(P<0.05)。增加用药剂量和改变用药方式,口腔粘膜炎和腹泻的发生率不同,差异具有显著性。结论化疗前测定UH2/U值可预测5-Fu的化疗毒性,并为个体化治疗提供依据。

Objective This study is to investigate the relationship between the UH2-U ratio and gastrointestinal toxicity with 5-Fu chemotherapy, and prove evidence of theory in tumoral treatment of individual. Methods 70 patients included 48 colorectal patients, 21 nasopharynx patients and 1 esophageal patient. Endogenous uracil and dihydrouracil were assayed by HPLC （High performance liquid chromatography）. The UH2-U ratio ≥2.05 was normal value. Results There were 53 patients whose UH2-U ratios were normal. The grade Ⅰ～Ⅱ nausea/vomiting , diarrhea and mucosal respectively was 35, 26 and 17 patients. The patients whose UH2-U ratio 〈2. 05 respectively was 7, 7 and 9 patients. Grade Ⅲ～Ⅳ occurred in 9, 9 and 7 patients. Which was significantly different （P〈0. 05）. Diarrhea and mucosal were of statistic significance in different dosage and different infusion methods. Conclusion UH2-U ratio can be used to predicate the toxicity of 5-Fu and to adjust the dose of 5-Fu or to change the therapy regimen before the treatment.