摘要
目的:探讨肺癌患者化疗后发生药物性肝损伤的特点,为临床用药提供参考。方法:回顾性分析甘肃省肿瘤医院(以下简称"我院")2010年1月至2014年12月纳入临床路径病种行首次化疗的453例肺癌患者病历,统计应用不同化疗方案后药物性肝损伤的发生率、严重程度、临床类型、预后情况。结果:我院3种肺癌化疗方案EP方案(依托泊苷+顺铂)、GP方案(吉西他滨+顺铂)及DP方案(多西他赛+顺铂)的肝损伤发生率分别为6.2%(7/113)、15.9%(30/189)和7.3%(11/151),其中GP方案的肝损伤发生率明显高于EP、DP方案,差异均有统计学意义(P<0.05),EP、DP方案肝损伤发生率的差异无统计学意义(P>0.05);不同的化疗方案所致肝损伤类型不同,DP方案所致肝损伤多表现为胆汁淤积型肝损伤(63.6%,7/11),EP方案多表现为混合型肝损伤(71.4%,5/7),GP方案多表现为肝细胞损伤型(56.7%,17/30);三种化疗方案所致的肝损伤均能治愈或转归。结论:三种肺癌化疗方案中,GP方案所致肝损伤的发生率较高且较严重,各方案所致肝损伤的类型各有特点,临床可根据其特点进行针对性的防治。
OBJECTIVE:To investigate the characteristics of drug-induced liver injury in patients with lung cancer after chemotherapy,so as to provide reference for clinical drug use.METHODS:Retrospective analysis was conducted on453patients with lung cancer who were included in the first-line chemotherapy for clinical pathology in Gansu Provincial Cancer Hospital(hereinafter referred to as“our hospital”)from Jan.2010to Dec.2014.The incidence,severity,clinical type,patient characteristics and prognosis of drug-induced liver injury after different chemotherapy regimens were statistically applied.RESULTS:The incidence of liver injury in three lung cancer chemotherapy regimens of EP regimen(etoposide+cisplatin),GP regimen(gemcitabine+cisplatin)and DP regimen(docetaxel+cisplatin)was6.2%(7/113),15.9%(30/189)and7.3%(11/151),and the incidence of liver injury in GP regimen was significantly higher than that in EP and DP regimes,and the difference was statistically significant(P<0.05),and there was no significant difference in the incidence of liver injury between EP and DP regimens(P>0.05).The types of liver injury caused by different chemotherapy regimens were different,the liver injury induced by DP regimen was mostly cholestasis-type liver injury(63.6%,7/11),and the EP regimen showed mixed liver injury(71.4%,5/7),GP regimen was mostly manifested as hepatocyte injury-type liver injury(56.7%,17/30).Liver damage induced by three chemotherapy regimens can be cured or returned.CONCLUSIONS:Among the three lung cancer chemotherapy regimens,the incidence of liver injury induced by GP regimen is higher and more serious.The types of liver injury induced by each regimen have different characteristics,and the clinical prevention and treatment can be carried out according to these characteristics.
作者
丁晓霞
白兆琴
冯晶
许颖
范春玲
达朝亮
金育忠
DING Xiaoxia;BAI Zhaoqin;FENG Jing;XU Ying;FAN Chunling;DA Chaoliang;JIN Yuzhong(Dept.of Pharmacy,Gansu Provincial Cancer Hospital, Gansu Lanzhou730050,China)
出处
《中国医院用药评价与分析》
2018年第11期1558-1560,1563,共4页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
甘肃省卫生行业科研计划管理项目(No.GWGL2014-32)
关键词
肺癌
化疗方案
药物性肝损伤
保肝药
Lung cancer
Chemotherapy regimens
Drug-induced liver injury
Liver-protecting drugs
