吉西他滨联合顺铂化疗对非小细胞肺癌合并轻度低蛋白血症患者的安全性评价  

Safety evaluation of chemotherapy of gemcitabine combined with cisplatin in non-small cell lung cancer patients with mild hypoalbuminemia

作　　者：李晓兵[1] 薛玉梅[2] 柴爱军[1] 马骖[3] 张淼[3] 张燕[3] LI Xiao-bing;XUE Yu-mei;CHAI Ai-jun;MA Can;ZHANG Miao;ZHANG Yan(a.Department of Pharmacy;b.Department of Neurolog;c.Departmentof Oncology,The First Hospital of Shijiazhuang,Shijiazhuang 050011,China)

机构地区：[1]石家庄市第一医院药学部,石家庄050011 [2]石家庄市第一医院神经内科,石家庄050011 [3]石家庄市第一医院肿瘤内科,石家庄050011

出　　处：《中国临床药理学杂志》2018年第21期2563-2565,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察非小细胞肺癌(NSCLC)患者合并轻度低白蛋白血症应用吉西他滨联合顺铂(GP方案)化疗后的安全性。方法将144例NSCLC患者根据化疗前白蛋白水平分为试验组(白蛋白水平为30～40 g·L^(-1)) 59例和对照组(白蛋白水平为40～55 g·L^(-1)) 85例。2组均给予GP方案化疗(第1,8天,静脉滴注吉西他滨1250 mg·m^(-2),第1～3天,静脉滴注顺铂25 mg·m^(-2))。比较2组患者单次化疗后的药物不良反应发生情况。结果 2组患者的药物不良反应发生类别相同,常见的有恶心、呕吐、血小板减少、白细胞减少和肝肾功能损伤,除骨髓毒性外,2组均未出现其他Ⅲ～Ⅳ级药物不良反应。试验组和对照组患者的骨髓抑制(28. 81%,25. 88%)、Ⅲ～Ⅳ级骨髓抑制(3. 39%,3. 53%)、消化道反应(23. 73%,23. 53%)、肝功能损伤(16. 95%,14. 12%)、肾功能损伤(13. 56%,12. 94%)、神经损伤(5. 08%,4. 7%)、皮疹(8. 47%,8. 24%)及类流感样症状(5. 08%,5. 88%)发生率比较,差异均无统计学意义(均P> 0. 05)。结论非小细胞肺癌患者在轻度低蛋白血症时,应用GP方案化疗未增加药物不良反应的发生率,从安全性角度考虑,对于合并轻度低白蛋白血症的NSCLC患者选择GP方案是较好的选择。Objective To evaluate the safety of gemcitabine combined with cisplatin in the treatment of patients with non-small cell lung cancer（ NSCLC） complicated with mild hypoalbuminemia. Methods A total of 144 patients with NSCLC were divided into treatment group（ albumin level 30-40 g · L^-1,n = 59） and control group（ albumin level 40-55 g·L^-1,n = 85）. The two groups were given GP regimen chemotherapy（ gemcitabine 1250 mg·m^-2,d 1,8 ＋ cisplatin 25 mg·m^-2,d 1-3,administrated by intravenous drip,ivgtt）. The occurrence of adverse drug reactions in two groups after once cycle of chemotherapy were compared. Results The two groups had the same types of adverse drug reactions,such as nausea,vomiting,thrombocytopenia,leucocyte reduction and liver and kidney injury. Except for the toxicity of bone marrow,there were no other adverse drug reactions grade Ⅲ-Ⅳ happened in two groups. There were no significant difference in the incidence of adverse drug reactions in treatment group and control group such as myelosuppression（ 28. 81 %, 25. 88 %）, grade Ⅲ-Ⅳmyelosuppression（ 3. 39%,3. 53%）,digestive tract reaction（ 23. 73%,23. 53%）,liver function injury（ 16. 95%,14. 12%）,renal function injury（ 13. 56%,12. 94%）,nerve injury（ 5. 08%,4. 7%）,rash（ 8. 47%,8. 24%） and influenza like symptoms（ 5. 08%,5. 88%）（ all P〉0. 05）. Conclusion Chemotherapy with GP regimen do not increase the incidence of adverse drug reactions in NSCLC patients with mild hypoproteinemia. GP regimen should be the better selection for safety in NSCLC patients with mild hypoproteinemia.

关 键 词：非小细胞肺癌 吉西他滨 顺铂 低白蛋白血症 

分 类 号：R979.1[医药卫生—药品]