不同剂量双环醇预防非M3型AML大剂量阿糖胞苷化疗相关性肝损伤的临床疗效观察  

The effectiveness of different doses of bicyclol for preventing high dose cytarabine induced DILI in patients with non-M3AML

作　　者：曹隽[1] 黄竹筠[1] 贺远[1] 朱红倩[1] 王麟辉[1] 丁倩[1] 肖仕珊[1] 王清[1] 宋军[1] 郭鹏翔[1] , HUANG Zhu-yun, HE Yuan ,ZHU Hong-qian ,WANG Ling-hui ,DING Qian, XIAO Shi-shan ,WANG Qing ,SONG Jun ,GUO Peng-xiang(Department of Hemotology,the People＇s Hospital of Guizhou Province,Guiyang 550001 ,Chin)

机构地区：[1]贵州省人民医院血液科,贵州贵阳550001

出　　处：《中国中西医结合消化杂志》2018年第7期596-600,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：[目的]评估不同剂量双环醇预防非M3型急性髓系白血病(AML)患者大剂量阿糖胞苷化疗相关性肝损伤的临床疗效。[方法]收集初治非M3型AML患者150例,将患者随机分为BI75(双环醇75mg口服,n=50)、BI150(双环醇150mg口服,n=50)及阿托莫兰组(2g/d,n=50)。分别于中剂量阿糖胞苷化疗前、化疗后7、14d对肝功能指标进行监测,共监测3个疗程。[结果]阿托莫兰组在3个疗程中,其预防药物性肝损伤(DILI)发生的疗效均低于BI150及BI75组;此外,从第2疗程起,BI75的DILI发生率即明显高于BI150组,且随疗程次数的递增,这种差异性有逐渐增高的趋势。此外,大剂量阿糖胞苷相关性DILI患者年龄较大(约半数为50~59岁)、且多发生于接受2~3次大剂量阿糖胞苷者(83.86%)。[结论]双环醇可有效预防大剂量阿糖胞苷所致的DILI,而150mg/d较75mg/d疗效更为显著。[Objective]To evaluate the effectiveness of different doses of bicyclol for preventing High dose cytarabine induced DILI in patients with non-M3 AML.[Methods]A total of 150 cases patients with non-M3 AML were collected.All of patients were randomly divided into three groups which named with BI75,BI150 and GSH groups according to whether patients were treated by bicyclol with 75 mg per day or150 mg per day and GSH.The liver function were monitored day 7 and day 14 after the middle-dose cytarabine chemotherapy.There were 3 cycles in total to be monitored.[Results]GSH group showed the higher incidence of DILI in all of three cycles compared with other two groups.In addition,BI150 group showed the better effectiveness on preventing DILI than BI75 group in the second and third cycle of high dose AraC.Furthermore,patients with DILI showed the elder age and mostly had accepted 2-3 cycles of chemotherapy.[Conclusion]Bicyclol showed the better potential in preventing DILI induced by high dose Ara-C,and bicyclol with 150 mg per day was better than 75 mg per day.

关 键 词：急性髓系白血病 预防性治疗 大剂量阿糖胞苷 

分 类 号：R733.71[医药卫生—肿瘤]