直肠癌术后肝转移患者FOLFIRI化疗后肠道黏膜功能变化分析

The changes of intestinal mucosal function in patients of liver metastasis after resection of rectal cancer treated by FOLFIRI

目的:探讨直肠癌手术治疗后发生肝转移患者采用FOLFIRI方案(5-氟尿嘧啶+四氢叶酸钙+伊立替康)化疗对患者肠道黏膜功能的影响作用。方法:观察我院肿瘤科2011年9月至2013年8月收集的55例直肠癌术后发生肝转移患者采用FOLFIRI化疗方案前后肠道黏膜功能的变化情况,检测化疗前与化疗后不同时间患者血清白蛋白、前白蛋白、血浆D-乳酸、尿液中乳果糖/甘露醇(L/M)值、血浆内毒素值的水平。结果:55例患者血清白蛋白化疗前为(37.62±1.72)g/L、前白蛋白为(367.4±7.3)mg/L,均显著高于化疗后第1、3、7、9天(P<0.05),化疗后第9天的血清白蛋白、前白蛋白化疗后第7天有所升高(P<0.05)。化疗后第1、3、7、9天的血浆D-乳酸水平较化疗前明显升高(P<0.05)。与化疗前相比,化疗后第1、3、7、9天的L/M值表现为逐渐上升趋势,化疗后第9天的L/M值显著高于化疗前(P<0.05)。化疗前本组患者均无腹痛、腹泻发生,随着化疗时间的延长,化疗患者的腹痛、腹泻率逐渐增高,在化疗第7天达到最高值(腹痛率87.27%、腹泻率34.55%),在化疗后第9天有所降低(腹痛率83.64%、腹泻率27.27%)。结论:直肠癌术后肝转移患者采用FOLFIRI方案治疗会引起肠道黏膜功能障碍,肠道通透性增加。

Objective：To study the influence with FOLFIRI chemotherapy of the intestinal mucosal function of the rectal cancer patients after surgical treatment.Methods：The changes of intestinal mucosal function before and after FOLFIRI chemotherapy in patients with liver metastasis were observed in 55 cases of rectal cancer patients.Results：In 55 patients serum albumin before chemotherapy was （37.62 ±1.72）g/L,prealbumin （367.4±7.3）mg/L,signif-icantly higher than that of postchemotherapy in the 1st,3rd,7th,9th day（P〈0.05）.The level of D-lactic acid was obviously higher than that of the 1st,3rd,7th,9th day of postchemotherapy.Before chemotherapy patients had no ab-dominal pain,diarrhea.After chemotherapy,abdominal pain,diarrhea rates were increased,reaching the highest value in the 7th day of chemotherapy（87.27% for abdominal pain,34.55% for diarrhea）.Conclusion：FOLFIRI regimen in the treatment can induce dysfunction of rectal cancer.