摘要
目的:评价血管紧张素转换酶抑制剂(angiotensin-converting-enzyme inhibitor,ACEI)联合吉西他滨化疗治疗改善晚期胰腺癌的疗效和不良反应。方法:回顾性收集首都医科大学附属北京友谊医院诊治晚期胰腺癌合并高血压患者68例,按照其服用降压药物的种类分为ACEI+吉西他滨化疗组和钙离子通道阻滞剂(calcium channel blocker,CCB)+吉西他滨化疗组,观察两组总生存期(overall survival,OS)和无进展生存期(progression-free survival,PFS)差异。结果:ACEI+吉西他滨化疗组OS为12.26±2.81个月,CCB+吉西他滨化疗组OS为(9.68±1.65)个月。ACEI+吉西他滨化疗组FPS为(7.17±1.54)个月,CCB+吉西他滨化疗组PFS为(5.35±1.12)个月。COX回归分析结果表明:ACEI与CCB的使用以及ECOG评分是OS的独立危险因素,HR分别为3.000(95%CI 1.70~5.29,P<0.05),3.722(95%CI 2.22~6.24,P<0.05)。PFS的独立影响因素与OS一致。其余年龄、性别、肿瘤部位以及高血压的严重程度均未对OS和PFS构成显著影响(P>0.05)。结论:ACEI联合吉西他滨化疗治疗有可能改善晚期胰腺癌的预后,可在高血压合并胰腺癌患者中尝试应用。
Objective： To evaluate the recent curative efficacy and security of angiotensin-converting-enzyme inhibitor （ACEI） in combination with chemotherapy treated patients with advanced pancreatic carcinoma and hypertension. Methods： Sixty-eight cases of advanced pancreatic cancer treated in Beijing Friendship Hospital were retrospectively collected; according to the types of antihypertensive drugs, the patients were divided into an ACEI ＋ gemcitabine chemotherapy group and a calcium channel blocker （CCB） ＋ gemcitabine chemotherapy group, and the difference in overall survival （OS） and progression-free survival （PFS） between two groups of patients were observed. Results： The OS of the ACEI ＋ gemcitabine chemotherapy group was （12.26±2.81） months, while （9.68±1.65） months in the CCB ＋ gemcitabine chemotherapy group. The PFS of ACEI ＋ gemcitabine chemotherapy group was （7.17±1.54） months, and （5.35±1.12） months in the CCB ＋ gemcitabine chemotherapy group. The difference in OS and FPS between the two groups was all statistically significant （P〈0.005）. Cox regression analysis showed that the use of CCB and ACEI and ECOG score are independent risk factors of the OS and PFS, HR of OS in the two groups were 3.000 （95% CI 1.70–5.29, P〈0.05）. The independent risk factors of PFS were the same as OS. The age, sex, tumor site, and the severity of hypertension are not of significant value （P〉0.05） to the OS and PFS. Conclusion： ACEI combination gemcitabine chemotherapy may improve the prognosis of advanced pancreatic cancer, and can be applied in patients with pancreatic cancer and hypertension.
出处
《临床与病理杂志》
2017年第10期2152-2157,共6页
Journal of Clinical and Pathological Research
基金
首都卫生发展科研专项基金(2016-4-1112)
北京市医院管理局"青苗"计划专项经费(QML20150107)
北京市中医药科技发展资金项目(QN2015-08)
首都医科大学附属北京友谊医院院启动基金(yyqdkt2014-10)~~
关键词
血管紧张素转化酶抑制剂
化学治疗
胰腺癌
高血压
angiotensin-converting-enzyme inhibitor
chemotherapy
pancreatic carcinoma
hypertension
