卡培他滨联合多西他赛对乳腺癌肝转移患者肠道菌群、肝功能及临床预后的影响分析

Effect of capecitabine combined with docetaxel on intestinal flora, liver function, and clinical prognosis in patients with breast cancer liver metastases

背景目前乳腺癌的患病率一直处于上升的趋势.虽然医疗技术发展乳腺癌得到有效的控制,但乳腺癌淋巴道转移使得患者寿命缩减至9mo到2年不等.乳腺癌肝转移为其中转移高发的一种,且恶化程度最为严重.目前作为对肝转移有效的治疗方法为化疗,而化疗的副作用较多,临床上应用辅助化疗药物以减少其副作用对患者自身影响.目前维持化疗常用的有卡培他滨及内分泌药物等.本研究中使用卡培他滨,它是目前治疗乳腺癌肝转移的有效药物之一,对患者的肝脏起到一定的积极作用,可以提高肝脏的少部分功能如谷丙转氨酶(alanine aminotransferase,ALT)及谷草转氨酶(aspartate aminotransferase, AST),对患者的寿命增长有一定的积极意义.目的探究卡培他滨联合多西他赛对乳腺癌肝转移患者肠道菌群、肝功能及临床预后的影响及分析.方法选取天津市泰达医院2015-08/2018-08临床资料齐全的乳腺癌肝转移患者72例,随机分成两组,各36例,分别进行不同药物治疗, A组给予卡培他滨联合多西他赛进行治疗, B组给予卡培他滨联合长春瑞滨进行治疗,比较两组患者治疗前肠道菌群、肝功能及临床预后的各项相关指标变化.结果两组治疗后肠道菌群比较差异显著,有统计学意义(P <0.05),其中肠球菌、双歧杆菌、乳杆菌、肠球菌菌落计数A组显著高于B组,葡萄球菌菌落计数A组显著低于B组.两组治疗后血浆内毒素、ALT和AST水平与治疗前对比,差异有统计学意义(P<0.05),其中A组血浆内毒素、ALT和AST水平的下降幅度大于B组.两组治疗后疗效差异无统计学意义(P>0.05).结论根据两组在肠道菌群、肝功能及临床预后各项相关得到指标比较,可以得出卡培他滨联合多西他赛组在治疗乳腺肝癌转移患者的疗效上略微比卡培他滨联合长春瑞滨取得更积极的作用.所以,卡培他滨联合多西他赛对乳腺癌肝转移患者肠道菌群、肝功能及临床预后具有一定的积极作用.

BACKGROUND The prevalence of breast cancer is currently on the rise.Although the development of medical technology has resulted in effective control of breast cancer, lymphatic metastasis of breast cancer reduces the lifespan of patients to 9 mo to 2 years. Breast cancer liver metastasis is a common form of metastasis and is very serious.At present, chemotherapy as an effective treatment for liver metastasis, has many side effects, and adjuvant chemotherapy drugs are used clinically to reduce the side effects of the patients. Currently, capecitabine and endocrine drugs are commonly used in maintenance chemotherapy. Capecitabine, one of the effective drugs for the treatment of liver metastasis of breast cancer,can somewhat improve liver function parameters such as alanine aminotransferase(ALT) and aspartate aminotransferase(AST) and has a positive effect on patient survival.AIM To investigate the effect of capecitabine combined with docetaxel on intestinal flora, liver function, and clinical prognosis in patients with liver metastases from breast cancer. METHODS From August 2015 to August 2018, 72 patients with liver metastases from breast cancer were randomly divided into two groups(A and B), with 36 patients in each group. Group A was treated with capecitabine combined with docetaxel, and group B was treated with capecitabine combined with vinorelbine. The changes of intestinal flora and liver function and clinical prognosis were compared between the two groups.RESULTS After treatment, the changes in intestinal flora were significantly different between the two groups(P < 0.05). Compared with the pretreatment values, there were significant improvements in plasma endotoxin and liver function parameters(ALT and AST) in both groups A and B after treatment(P < 0.05). After treatment, the levels of plasma endotoxin, ALT, and AST in group A were significantly higher than those in group B(P < 0.05). There was no significant difference in clinical prognosis between the two groups after treatment(P > 0.05). CONCLUSION Capecitabine combined with docetaxel has a slightly more active effect in the treatment of metastatic breast cancer than capecitabine combined with vinorelbine, because capecitabine combined with docetaxel has a positive effect on intestinal flora, liver function, and clinical prognosis in these patients.