强阿片药物对阿片耐受的晚期癌症患者肝功能的影响  

Effect of opioids on liver function in opioid-toleranced patients

作　　者：王晓芳[1] 王玉梅[1] 

机构地区：[1]中国医科大学附属盛京医院宁养病房,沈阳110021

出　　处：《实用药物与临床》2014年第5期554-557,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的观察阿片耐受患者用药前后肝功能水平的变化,探讨长期应用强阿片类药物对患者肝功能的影响。方法搜集我院52例联合或单独使用吗啡、羟考酮、芬太尼超过30 d的晚期癌症患者,进行疼痛治疗情况分析,并比较用药前后血清肝功能水平。结果晚期癌症患者在使用耐受剂量强阿片类药后1周、2周及1个月肝功能无显著变化(P>0.05),在患者病程终末期谷草转氨酶、直接胆红素、间接胆红素水平与用药初期相比,差异有统计学意义(P<0.05)。结论规范合理使用强阿片类药物初期不会导致肝损伤,长期应用应监测患者肝功能水平;对于癌症患者进行规范化癌痛治疗,可确保存在肝损伤风险的患者在使用强阿片类药物后,不会显著增加肝损伤的风险。Objective To observe the change of liver function before and after treatment in patients with opioid tolerance and investigate the effects of long-term application of strong opioid drugs on liver function of patients.Methods 52 cases of terminal cancer patients in our hospital who used morphine,oxycodone,fentanyl joint or alone for more than 30 days were selected and the treatment of pain and compare serum level of liver function before and after medication were analyzed. Results The liver function of terminal cancer patients with tolerable dose strong opioid drugs for 1 weeks,2 weeks and 1 month had no significant change（P ＆gt; 0. 05）. The level of aspartate aminotransferase,direct bilirubin,indirect bilirubin in patients with end-stage levels had significant difference compared with the initial treatment（P ＆lt; 0. 05）. Conclusion Normative and rational use of strong opioids at the initial stage does not lead to liver damage,but long-term use of strong opioids should monitor the liver function of patients;Standardized pain treatment for patients with cancer can ensure that patients at risk of liver damage after using strong opioids will not significantly increase the risk of liver damage.

关 键 词：阿片类药物 晚期癌痛 肝功能 

分 类 号：R730.5[医药卫生—肿瘤]