摘要
目的研究急性非淋巴细胞白血病(AML)患者化疗肝损伤的发生率,并对其相关因素进行分析。方法回顾分析天津医科大学总医院血液科自1997年1月至2006年12月收治的70例急性非淋巴细胞白血病患者,统计其化疗肝损伤发生率,利用χ2检验、Logistic回归等统计方法,研究相关因素对化疗肝损伤发生率的影响。结果70例AML患者化疗肝损伤发生率为65.7%,其中轻度肝损伤38.6%,中度肝损伤17.1%,重度肝损伤10.0%。单因素分析显示,疗程中发生感染、输血及合用青霉素、头孢菌素、氨基糖苷类、唑类抗真菌药等药物可增加化疗肝损伤的发生率(P<0.05);诱导缓解比巩固缓解更易发生化疗肝损伤(P<0.05);AML-M3患者应用全反式维甲酸诱导缓解比其他方案更易发生化疗肝损伤(P<0.05);还原型谷胱甘肽是肝损伤的保护因素(P<0.05);化疗肝损伤的发生与患者年龄、性别、白血病类型、化疗方案等因素无显著相关。多因素分析显示,感染及头孢菌素的应用是化疗肝损伤的独立影响因素(P<0.05)。结论AML化疗肝损伤发生率较高。疗程中发生感染、合用头孢菌素等是化疗肝损伤的高危因素。预防性应用还原型谷胱甘肽可降低化疗肝损伤的发生。
Objective To investigate the incidence and risk factors of chemotherapy-induced liver disease of AML patients. Methods Liver disease was classified into three grades as mild, moderate and severe according to the criteria established on European Drug Conference in 1990. Seventy cases of AML patients were studied who received treatment in the hematological department of General Hospital of Tianjin Medical University from 1997 to 2006. Statistics methods such as Chi-square test and Logistic Regression were used to investigate the correlation between the incidence and the risk factors of liver disease. Results The incidence of liver disease of seventy AML patients was 65. 7%, including 38.6% mild, 17. 1% moderate and 10. 0% severe liver disease. Single factor analysis showed that infection, blood transfusion, synchronous use of penicillin, eephalosporins, aminoglycosides, azoles could increase the incidence of liver disease （ P 〈 0. 05 ） ; Liver disease was more common in the treatment of inducing remission and the regimen of ATRA （ P 〈 0. 05 ） ; Glutathione was a protecting factor（ P 〈 0. 05 ）. The incidence of liver disease was not significantly correlated with age, gender,types of leukemia,or the regimens（ P 〉 0. 05 ）. Multivariate factor analysis showed that infection and synchronous use of cephalosporins were independent risk factors of liver disease （ P 〈 0. 05 ）. Conclusion The risk factors of ehemotherapy-ihdueed liver disease include infection, synchronous use of eephalosporins, treatment of inducing remission, and regimen of ATRA. Prophylactic use of glutathione could decrease the incidence of liver disease.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2009年第11期1009-1011,共3页
Chinese Journal of Practical Internal Medicine
基金
天津市科技支撑计划项目(07ZCGYSF00600)
高校博士点基金项目(200800620004)
关键词
肝损伤
化疗
白血病
急性
非淋巴性
liver disease
chemotherapy-induced
leukemia
acute
non-lymphocytic
