奥美拉唑对结直肠癌患者卡培他滨血药浓度与化疗有效性及毒副反应的影响

Effects of omeprazole on plasma concentration,efficacy and adverse reactions of capecitabine in patients with colorectal cancer

目的探讨奥美拉唑对结直肠癌患者卡培他滨血药浓度、化疗有效性及毒副反应的影响。方法选取2017年1月至2018年12月本院使用奥沙利铂联合卡培他滨(XELOX方案)化疗的144例结直肠癌患者为研究对象,按照随机数字法将患者分为两组,各72例。对照组未用奥美拉唑,研究组加用奥美拉唑。比较两组患者的卡培他滨代谢产物氟尿嘧啶血药浓度、化疗有效率和毒副反应,观察两组患者的无进展生存时间(PFS)。结果对照组卡培他滨代谢产物氟尿嘧啶的血药浓度为(123.09±56.70)μg/ml,与研究组(126.25±50.59)μg/ml比较,差异无统计学意义(P>0.05);研究组Ⅲ~Ⅳ级骨髓抑制、恶心呕吐、腹泻、手足综合征发生率分别为13.8%、0.0%、0.0%、19.4%,与对照组11.1%、0.0%、0.0%、23.6%比较,差异均无统计学意义(均P>0.05);对照组反酸烧心发生率为72.2%,明显高于研究组44.4%,差异有统计学意义(P<0.05);研究组客观缓解率为40.3%,与对照组43.1%比较,差异无统计学意义(P>0.05);研究组中位PFS为8.0个月,与对照组8.5个月比较,差异无统计学意义(P>0.05)。结论奥美拉唑不影响卡培他滨的血药浓度、疾病缓解率,对患者的PFS也无明显影响,但可以缓解患者的反酸烧心症状。

Objective To explore the effects of omeprazole on plasma concentration,efficacy,and adverse reactions of capecitabine in patients with colorectal cancer.Methods 144 patients with colorectal cancer treated with oxaliplatin and capecitabine(XELOX regimen)in our hospital from January,2017 to December,2018 were selected as the study objects.According to the random number method,the patients were divided into a control group,treated without omeprazole,and a study group,added with omeprazole,with 72 cases in each group.The plasma concentrations,efficacies,and adverse reactions of capecitabine metabolite fluorouracil were compared between two groups.The progression-free survival time(PFS)was observed in both groups.Results The plasma concentration of capecitabine metabolite fluorouracil in the control group was(123.09±56.70)μg/ml,and that in the study group(126.25±50.59)μg/ml,with no statistical difference(P>0.05).The incidences ofⅢ-Ⅳbone marrow suppression,nausea and vomiting,diarrhea,and hand-foot syndrome of the study group were 13.8%,0.0%,0.0%,and 19.4%,and those of the control group 11.1%,0.0%,0.0%,and 23.6%,with no statistical differences(all P>0.05).The incidence of reflux heartburn in the control group was 72.2%,which was significantly higher than that of the study group(44.4%,P<0.05).The objective remission rate of the study group was 40.3%,and that of the control group 43.1%(P>0.05).The median PFS of the study group was 8.0 months,and that of the control group 8.5 months(P>0.05).Conclusion Omeprazole does not affect the plasma concentration of capecitabine or disease remission rate,nor does it significantly affect the patients'PFS,but it relieves the patients'reflux heartburn symptom.