56例抗肿瘤药物致肝损伤临床特点分析  

Clinical features of liver injury induced by antitumor drugs:An analysis of 56 cases

作　　者：张惠娟 史祖宣[2] 赵兰芳 高天慧[2] 李健[3] ZHANG Huijuan;SHI Zuxuan;ZHAO Lanfang(Department of Medical Care, The First Affiliated Hospital of Hainan Medical College, Haikou 570102, China)

机构地区：[1]海南医学院第一附属医院医疗保健科,海口570102 [2]河南省人民医院肿瘤内科,郑州450003 [3]河南省人民医院消化内科,郑州450003

出　　处：《临床肝胆病杂志》2019年第3期574-578,共5页Journal of Clinical Hepatology

基　　金：河南省科技攻关项目(172102310370)

摘　　要：目的分析恶性肿瘤治疗过程中抗肿瘤药物所致药物性肝损伤(DILI)的临床特点。方法回顾性分析河南省人民医院2015年1月-2016年12月确诊为恶性肿瘤且在抗肿瘤药物治疗期间出现DILI的56例患者的临床资料,包括性别、年龄、原发肿瘤类型、嗜肝病毒感染情况、肝功能、化疗药物种类、肝损伤发生时间、保肝药物应用情况及治疗后肝损伤转归等。结果 56例抗肿瘤药物所致DILI中,临床分型以肝细胞损伤型为主(30例,53. 6%),损伤程度以轻度肝损伤为主(80. 4%,45/56)。以FOLFOX方案、GP/DP方案和CHOP方案多见,多药联合引起DILI比较高(89. 3%,50/56),常见药物为铂类、影响微管蛋白药物和烷化剂。DILI多发生在用药后1～2周之内(62. 5%,35/56)。结论 DILI以轻度、肝细胞损伤型为主,主要发生在用药后1～2周内,以铂类抗肿瘤药物及相关化疗方案最常见,多种抗肿瘤药物联合应用更易发生DILI,DILI预后良好。ObjectiveTo investigate the clinical features of drug-induced liver injury (DILI) caused by antitumor drugs during the treatment of malignant tumors. MethodsA retrospective analysis was performed for the clinical data of 56 patients who were diagnosed with malignant tumors in Henan Provincial People′s Hospital from January 2015 to December 2016 and experienced DILI during the treatment with antitumor drugs, including sex, age, type of primary tumor, hepatotropic virus infection, liver function, type of chemotherapeutics, onset time of liver injury, application of liver-protecting drugs, and outcome of liver injury. ResultsAmong the 56 patients with DILI caused by antitumor drugs, 30 (53.6%) had hepatocellular injury, and 45 (80.4%) had mild liver injury. FOLFOX, GP/DP, and CHOP were the most common regimens for DILI, and of all 56 patients, 50 (89.3%) had DILI caused by multiple drugs. Platinum-based drugs, anti-microtubule agents, and alkylating agents were the common drugs causing DILI. Of all 56 patients, 35 (62.5%) developed DILI within 1-2 weeks after medication. ConclusionDILI caused by antitumor drugs mainly has a mild degree and hepatocellular injury type is the most common clinical type. Platinum-based antitumor drugs and related chemotherapeutic regimens are the most common drugs for DILI. A combination of multiple antitumor drugs is more likely to cause DILI, and patients with such DILI often have a good prognosis.

关 键 词：抗肿瘤药 药物性肝损伤 

分 类 号：R575[医药卫生—消化系统]