化疗药物对胰腺癌患者肝功能的影响  

Study on chemotherapy-induced disorders of liver function in patients with pancreatic carcinoma

作　　者：戴月娣[1] 袁苏徐[1] 张德祥[1] 

机构地区：[1]苏州大学附属第一医院,江苏苏州215006

出　　处：《现代肿瘤医学》2007年第7期977-979,共3页Journal of Modern Oncology

摘　　要：目的:探讨胰腺癌患者接受抗肿瘤药治疗前后血清谷丙转氨酶(ALT)和谷草转氨酶(AST)变化及其临床意义,并分析其机理。方法:收集2000年1月～2004年12月收住本院的胰腺癌患者81例化疗前后的血清ALT、AST检验报告及相关临床资料,进行回顾性分析。结果:化疗后ALT、ALT/AST比值显著增高(P=0.0074,0.0001)。年老患者的ALT、AST化疗后升高幅度更大(P<0.05);多次化疗ALT、AST及ALT/AST升高幅度较首次大(P<0.05);胰体尾癌化疗后血清AST水平较胰头癌高;化疗前有总胆红素(TB)或ALT升高者化疗后ALT、AST下降(P<0.05)。未发现某种化疗药较其他药更易导致肝损害(P>0.05)。结论:大多数化疗所致的肝损为轻中度损害。多次化疗较首次化疗易发生重度肝损害。胰体尾癌较胰头癌易出现重度肝损。原有黄疸和轻度肝损患者化疗后不会加重,同时保肝治疗下甚至可能改善。胰腺癌的临床分期、是否发生转移以及肝脏有无转移对化疗引起的肝损影响不大。Objective： To explore the effect of the chemotherapy on serum ALT and AST in patients with pancreatic carcinoma and to find out it＇s mechanism. Methods： Serum ALT and AST in 81 cases with pancreatic carcinoma who had received chemotherapy from January 2000 to December 2004 in our hospital were analyzed retrospectively. Results ： Serum ALT and ALT/AST increased after chemotherapy. Serum ALT and AST of the older patients beyond median age increased more than that in younger patients bellow median age after chemotherapy. Serum ALT, AST and ALT/AST in patients who received chemotherapy for the first time increased sharper than that in patients who received chemotherapy for more than once. Serum AST of the body and tail of the pancreatic carcinoma patients were higher than that of the head of the pancreatic patients after chemotherapy. Serum ALT, AST in patients with serum total bilirubin and ALT beyond normal decreased after chemotherapy while those of the normal patients increased. There was no drugs had more tendency to induce disorder of liver function than the others. Conclusion： The liver damage induced by chemotherapy was mild. Patients who received chemotherapy more than once had more opportunity to get severe liver dysfunction than those who get for the first time. The body and tail of the pancreatic carcinoma patients had more tendencies to develop in severe liver dysfunction than the head of the pancreatic patients. Chemotherapy would not damage liver function of patients who had jaundice or mild liver dysfunction, moreover, might recover the former dysfunction simultaneously with protective liver function drugs. Clinic staging, distant metastasis and liver metastasis of pancreatic carcinoma had little effect on the liver dysfunction after chemotherapy.

关 键 词：胰腺癌 抗肿瘤药 谷丙转氨酶 谷草转氨酶 

分 类 号：R735.9[医药卫生—肿瘤]