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收稿日期:2008-10-6修回日期:2008-12-15

癌症恶病质的综合性治疗进展

邱正国v(综述),陈思曾(审校)

(福建医科大学附属第一医院普外科,福州350004)

中图分类号:R730.6文献标识码:A文章编号:1006-2084(2009)03-359-05

摘要:癌症恶病质(CC)是恶性肿瘤患者晚期常见的临床综合征之一。其病因、发病机制相当复杂,多种细胞因子和代谢物质都在CC的发生、发展中起重要影响,针对这些因素的治疗是目前的关注点。CC的治疗涉及营养补充、药物治疗、中医治疗、心理治疗等多方面的综合性治疗。现就CC目前的治疗手段和防治对策予以综述。

关键词:癌症恶病质;细胞因子;综合治疗

Comprehensive Treat m ent Prog res s in C ancer Cachex i a QIU Zheng-gu o,C HEN S i-ze ng.(D e part m ent of Genera l Surg e ry,t h e F irstH os p italAff ili a te d t o Fujian M e d ic a l Un i versit y,Fu zhou350004,Ch i na) Abstract:C ancer cach exi a(CC)is on e of cli n i c synd ro m es for m ali gnant tu m or pati en ts i n advanced stage.The eti op athogen i s i s and pat hogen esy are very co mp lex,wh ich as soci ated w ith mu c h cytok i ne and m etaboli n.The recent focu s is on thes e fact ors t o relieve CC.The treat m ent refer t o co m preh ens i ve m et hods, s u ch as nu triti onal supple m ent,phar m acy i nterventi on,traditi onal C hinese m ed ici ne and psychotherapy.The arti cle sa mm ari zes,t h e p reasent treat m en tm et hod and p reventi on m eas u res to CC.

K ey words:C ancer cachex i a;C yt ok i ne;C o m prehen sive treat m ent

癌症恶病质(cancer cachex ia,CC)主要是由肿瘤

的一些产物及机体释放的细胞因子引起的以全身代

谢紊乱为特征的一种继发性反应的临床综合征。临

床表现主要为食欲减退、体质量下降、全身衰竭以及

糖类、脂肪和蛋白质代谢异常。60%~80%的晚期肿瘤患者都存在此综合征,以胰腺癌和胃癌发生率最高[1]。当癌症患者体质量6个月内减轻5%以上,尤其合并有骨骼肌的消耗,这时应高度怀疑早期恶病质。CC也是癌症患者死亡的一种原因,是导致肿瘤患者高病死率和生存期缩短的一个重要因素。

CC患者许多生理改变

与单纯饥饿很相似,但CC患者几乎不能通过积极进食而完全恢复体质,显然还存在更为复杂的代谢机制。但是迄今为止,CC发生的确切发病机制和分子机制至今尚不完全清楚,不过已经通过大量的研究发现和其相关的一些代谢免疫异常和分子机制以及