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ACEI/ARB类药物对晚期胃癌合并高血压患者预后的影响
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| 篇名： | ACEI/ARB类药物对晚期胃癌合并高血压患者预后的影响 |
| TITLE： | |
| 摘要： | 目的：探讨血管紧张素转化酶抑制剂（ACEI）/血管紧张素Ⅱ受体阻滞剂（ARB）类药物对晚期胃癌合并高血压患者预后的影响。方法：采用回顾性研究法，收集2009年1月1日－2012年12月31日在浙江省肿瘤医院接受过至少2个周期含氟类药物的一线化疗方案，且经组织学证实为Ⅲ～Ⅳ期胃癌合并高血压患者的临床资料进行汇总分析。将其中服用ACEI/ARB类降压药物的患者设为试验组，服用其他降压药物的患者设为对照组，并进行电话随访。结果：符合入组条件的患者共124例，其中试验组患者（23例）与对照组患者（101例）除饮酒史外，在年龄、性别、吸烟史、体力状况评分、疾病家族史、肿瘤家族史、TNM分期、病理类型、肿瘤部位和化疗方案方面，差异均无统计学意义（P＞0.05）。试验组患者一线化疗的有效率为73.9％，明显高于对照组的41.6％，差异有统计学意义（P＜0.05）；两组患者的1年和3年生存率比较，差异无统计学意义（P＞0.05）；试验组患者的中位生存时间为669 d，明显长于对照组患者的410 d，差异有统计学意义（P＜0.05）。COX回归分析结果表明，一线化疗疗效对于不同降压药物组患者的生存有影响（P＜0.05）。结论：与其他降压药物相比，ACEI/ARB类药物使晚期胃癌合并高血压患者一线化疗的有效率显著提高，中位生存时间也显著延长，但对于生存率的影响并不明显；同时，尚缺乏对患者具体饮酒量的统计比较，有待于多中心、前瞻性、大样本的研究进一步证实。 |
| ABSTRACT： | OBJECTIVE： To explore the effects of angiotensin converting enzyme inhibitors （ACEI）/angiotensin Ⅱ receptor blockers （ARB） on the prognosis in patients with advanced gastric cancer complicated with hypertension. METHODS： By retrospective study， clinical information of histologically confirmed Ⅲ-Ⅳ stage advanced gastric cancer patients with hypertension receiving 2 cycles of first-line chemotherapy plan containing fluorouracil at least were collected from Zhejiang Tumor Hospital during Jan. 1st， 2009-Dec. 31th， 2012. The data were summarized and analyzed. The patients receiving ACEI/ARB drugs were included in trial group， and the patients receiving other antihypertensive drugs were included in control group. Telephone follow-up was conducted in 2 groups. RESULTS： A total of 124 patients meeting the inclusion criteria were enrolled in this study. There was no statistical significance in age， gender， smoking history， ECOG score， family history of disease， family history of tumor， TNM staging， pathological type， tumor site or chemotherapy plan between trial group （23 cases） and control group （101 cases）， except for history of alcohol intake （P＞0.05）. Total response rate of first-line chemotherapy was 73.9％ in trial group， which was significantly higher than 41.6％ of control group， with statistical significance （P＜0.05）. There was no statistical significance in 1-year or 3-year survival rate between 2 groups （P＞0.05）. Median survival time of trial group was 669 d， which was significantly longer than 410 d of control group， with statistical significance （P＜0.05）. Results of COX regression analysis showed that therapeutic efficacy of first-line chemotherapy influenced the survival of patients in different antihypertensive agent groups （P＜0.05）. CONCLUSIONS： Compared with other antihypertensive drugs， ACEI/ARB agents significantly improve response rate of first-line chemotherapy in patients with advanced gastric cancer complicated with hypertension， significantly prolong median survival time， but have no significant effect on survival rate； at the same time， statistical comparison of definite drinking amount are absent. It needs to be further confirmed by multi-center， prospective and large-scale sample. |
| 期刊： | 2017年第28卷第32期 |
| 作者： | 戚雅君，丁海樱，杨国浓，王增，罗沛华 |
| AUTHORS： | QI Yajun，DING Haiying，YANG Guonong，WANG Zeng，LUO Peihua |
| 关键字： | 晚期胃癌；高血压；血管紧张素转化酶抑制剂；血管紧张素Ⅱ受体阻滞剂；预后 |
| KEYWORDS： | Advanced gastric cancer； Hypertension； ACEI； ARB；Prognosis |
| 阅读数： | 272 次 |
| 本月下载数： | 4 次 |
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