胃肠道恶性肿瘤患者血清常量元素水平与化疗不良反应的相关性

Correlation between macroelements and adverse reaction in patients with gastrointestinal cancer during chemotherapy

目的探讨胃肠道恶性肿瘤患者常量元素水平与化疗所致不良反应的相关性。方法选取上海中医药大学附属普陀医院普外科及中医肿瘤科收治的胃肠道恶性肿瘤患者129例,在化疗前1d测定血清常量元素(钠、钾、钙、氯、镁)水平。观察化疗时不良反应的发生情况,比较有无不良反应患者的血清常量元素水平,分析化疗前患者血清常量元素水平与化疗不良反应发生率的相关性。结果无全身不良反应组的血清钙水平显著高于有全身不良反应组(P<0.05);化疗前血清钙水平与化疗所致全身不良反应发生率呈负相关(r=-0.29,P<0.05),与化疗所致消化系统不良反应(r=-0.19)及总不良反应发生率(r=-0.21)亦呈负相关(P值均<0.05)。无总不良反应组的血清钾水平显著高于有总不良反应组(P<0.05);化疗前血清钾水平与化疗所致全身不良反应发生率呈负相关(r=-6.86,P<0.05),与消化系统不良反应(r=-2.53)及总不良反应发生率(r=-2.66)呈负相关(P值均<0.05)。化疗前血清镁水平与消化系统不良反应发生率呈正相关(r=0.64,P<0.05)。结论胃肠道恶性肿瘤患者化疗的不良反应与其血清常量元素水平密切相关,可根据情况予以营养指导和适当调整常量元素的摄入,以减少化疗的不良反应,提高患者的耐受力。

Objective To investigate the correlation between serum microelement levels and chemotherapy tolerance in the patients with gastrointestinal cancer. Methods Totally 129 patients with gastrointestinal cancer admitted to the Department of General Surgery and Department of Oncology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine were enrolled in the study. The levels of serum microelements （sodium, potassium, calcium, chloride and magnesium） were measured on the day before chemotherapy. Adverse reaction after chemotherapy was recorded. The microelement levels were compared between the patients with and without adverse reaction, Results The serum calcium level in the patients with systemic adverse reaction was significantly lower than those without adverse reaction （P〈0. 057. Serum calcium level was negatively correlated with systemic adverse reaction, adverse reaction of digestive system and total adverse reaction caused by chemotherapy （r = - 0,29, -- 0.19, and - 0.21, respectively, P〈0.05）, so was the serum calcium level （r = - 6.86, - 2.53, and - 2.66, respectively, P〈0.05）. But serum magnesium level before chemotherapy was positively correlated with adverse reaction of the digestive system （ r=- 0.64, P 0.05）. Conclusion There is close correlation between the levels of serum macroelements and adverse reaction in patients with gastrointestinal cancer during chemotherapy. It is suggested that nutrition guidance and macroelement adjustment should be taken in order to reduce the adverse reaction and improve patient＇s tolerance.