紫杉醇联合卡铂静脉化疗相关肝损伤93例临床特点及治疗分析  

Clinical characteristics and treatment of 93 cases liver injury related to intravenous chemotherapy with paclitaxel combined with carboplatin

作　　者：张佳佳[1] 席明名[1] Zhang Jiajia;Xi Mingming(Department of Pharmacy,Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University,Nanjing Maternity and Child Health Care Hospital,Nanjing 210004,China)

机构地区：[1]南京医科大学附属妇产医院南京市妇幼保健院药学部,南京210004

出　　处：《中国实用医刊》2022年第24期1-5,共5页Chinese Journal of Practical Medicine

摘　　要：目的了解紫杉醇联合卡铂静脉化疗相关肝损伤的临床特点及治疗情况,为临床合理用药提供参考。方法抽取2019年1月至2021年10月南京医科大学附属妇产医院收治的卵巢癌患者93例,均于紫杉醇联合卡铂静脉化疗后出现肝损伤,经医院电子病历系统获取其临床资料进行回顾性分析。统计其化疗相关肝生化异常临床发生特点及治疗情况。结果93例紫杉醇联合卡铂化疗相关肝生化异常患者中,首次异常出现在前3周期者占74.2%(69/93);首次异常为单项指标异常者占50.5%(47/93),多项指标异常者占49.5%(46/93);首次异常严重程度为0级者占33.3%(31/93),1级者占54.8%(51/93);除首次异常外,后续周期也发生肝生化异常者占63.4%(59/93),末次异常严重程度分级较首次异常严重程度分级上升至少1个等级者占23.7%(14/59)。93例紫杉醇联合卡铂化疗患者共发生220例次肝生化异常,其中161例次进行保肝治疗,59例次未进行保肝治疗。采用单药治疗143例次,保肝方案主要为抗炎药物;采用联合治疗18例次,保肝方案包括2种抗炎药物、抗炎与解毒抗氧化药物。结论紫杉醇联合卡铂化疗导致的药物性肝损伤临床表现多样,治疗仍缺乏规范性。医药工作者应加强药物性肝损伤的诊疗,以更好地保障患者用药合理化。Objective To understand the characteristics and treatment of liver injury related to intravenous chemotherapy with paclitaxel combined with carboplatin,and provide reference for clinical rational drug use.Methods A total of 93 patients with ovarian cancer who were admitted to the Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University from January 2019 to October 2021 were selected,and all of them had liver injury after paclitaxel combined with carboplatin intravenous chemotherapy.Their clinical data were obtained through the hospital’s electronic medical record system for the retrospective analysis.The clinical characteristics and treatment of chemotherapy-related liver biochemical abnormalities were counted.Results Among the 93 patients with liver biochemical abnormalities related to paclitaxel combined with carboplatin chemotherapy,74.2%(69/93)patients had the first-time abnormality in the first three cycles;50.5%(47/93)first-time abnormality patients were with single index abnormalitiy,and 49.5%(46/93)patients were with multiple index abnormalities;33.3%(31/93)first-time abnormality patients were grade 0,and 54.8%(51/93)patients were grade 1;in addition to the first-time abnormality,63.4%(59/93)patients had liver biochemical abnormalities in subsequent cycles,of which 23.7%(14/59)patients had last abnormality severity grade increased by at least 1 grade compared with the first-time abnormality severity grade.A total of 220 cases of liver biochemical abnormalities occurred in the 93 patients treated with paclitaxel combined by carboplatin chemotherapy,of which 161 cases received hepatoprotective therapy and 59 cases did not receive liver protection treatment.A total of 143 cases were treated with monotherapy,and the hepatoprotective regimen was mainly anti-inflammatory drugs;there were 18 cases treated by combined treatment,while the hepatoprotective regimen included 2 kinds of anti-inflammatory drugs,anti-inflammatory and detoxification and antioxidant drugs.Conclusions The clinical mani

关 键 词：紫杉醇 卡铂 药物性肝损伤 

分 类 号：R575[医药卫生—消化系统]