不同化疗方案对肺癌合并慢性肾衰竭患者肾功能的影响  

Effect of Different Chemotherapy on the Renal Function of the Lung Cancer Patients Combined with Chronic Renal Failure

作　　者：赵燕仪[1] 卜庆[1] 李康慧[2] 石援援[1] 

机构地区：[1]桂林医学院附属医院肿瘤科,541001 [2]桂林医学院附属医院肾内科,541001

出　　处：《医学研究杂志》2015年第4期136-139,共4页Journal of Medical Research

基　　金：广西医药卫生自筹经费计划课题资助项目(Z2014322)

摘　　要：目的观察TC、DC、GC、PC 4种化疗方案对非小细胞肺癌合并慢性肾衰竭(代偿期)患者肾功能的影响。方法选择67例首次化疗的非小细胞肺癌患者,化疗前处于慢性肾衰竭(代偿期),患者年龄41~70岁,按所接受的方案分为4组:1TC组:紫杉醇135mg/m2,d1+卡铂AUC 5,d1,21天重复;2DC组:多西他赛75mg/m2,d1+卡铂AUC 5,d1,21天重复;3GC组:吉西他滨1000mg/m2,d1,8+卡铂AUC 5,d1,21天重复;4PC组(只限于非鳞癌患者):培美曲塞500mg/m2,d1+卡铂AUC 5,d1,21天重复;以肾小球滤过率代表其肾功能,检测化疗前及2程化疗后肾小球滤过率,比较不同化疗方案前后患者肾功能的变化。结果治疗前,4组患者肾小球滤过率为TC组77.1±16.41ml/min,DC组71.82±12.41ml/min,GC组74.86±10.42ml/min,PC组59.45±9.07ml/min;2程化疗后肾小球滤过率为TC组69.76±8.89ml/min,DC组66.21±13.5ml/min,GC组70.71±9.4ml/min,PC组61.75±10.77ml/min。TC组化疗后肾小球滤过率较前下降7.33±2.46ml/min,DC组化疗后肾小球滤过率较前下降5.61±2.63ml/min,差异均有统计学意义(P<0.05);GC组及PC组化疗前后肾小球滤过率改变差异无统计学意义(P>0.05);TC组化疗后肾小球滤过率下降程度高于DC组,差异有统计学意义(P<0.05)。结论对于非小细胞肺癌合并慢性肾衰竭(代偿期)患者,使用GC、PC方案化疗对肾功能无明显不良影响,而TC、DC方案可能引起肾功能下降,其中TC方案引起的肾功能不良反应程度高于DC方案。Objective To investigate the effect of different chemotherapy( TC,DC,GC,PC) on the renal function of the lung cancer patients combined with chronic renal failure( compensated stage).Methods Sixty seven cases of non-small cell lung cancer patients were selected for their first chemotherapy treatment,all of whom combined with the chronic renal failure( compensated stage) before chemotherapy.Their age ranged from 41 to 70.According to the chemotherapy scheme,they were dirided into four groups:( 1) TC group:taxol135 mg / m2,d1 + carboplatin AUC 5,d1,21 days repeat;( 2) DC group:docetaxel 75 mg/m2,d1 + carboplatin AUC 5,d1,21 days repeat;( 3) GC group:gemcitabine 1000 mg / m2,d1,8 + carboplatin AUC 5,d1,21 days repeat;( 4) PC group( limited to non-squamous carcinoma) :pemetrexed 500 mg / m2,d1 + carboplatin AUC 5,d1,21 days repeat.The glomerular filtration rate which representing the renal function was detected before as well as after the second cycles of chemotherapy,compared the change of renal function in patients involved different chemotherapy scheme.Results Before the treatment,the glomerular filtration rate of four groups were:TC group( 77.1 ± 16.41) ml/min,DC group( 71.82 ± 12.41) ml/min,GC group( 74.86 ± 10.42) ml/min,PC group( 59.45 ± 9.07) ml/min;after the second cycle chemotherapy,the glomerular filtration rate respectively were( 69.76 ± 8.89) ml / min( TC group),( 66.21 ± 13.5)ml / min( DC group),( 70.71 ± 9.4) ml / min( GC group),( 61.75 ± 10.77) ml / min( PC group).The glomerular filtration rate of TC group decreased by( 7.33 ± 2.46) ml / min after chemotherapy,as well as the glomerular filtration rate of DC group decreased by( 7.33 ±2.46) ml / min,and both of them were statistically significant( P < 0.05).The glomerular filtration rate changed in GC group and PC group had no statistical significance( P > 0.05).The glomerular filtration rate of TC group decreased more than that of DC group,and the difference was statistically significant( P < 0.05).Conclusion For non-small cell lung cancer pat

关 键 词：非小细胞肺癌 慢性肾衰竭 培美曲塞 吉西他滨 多西他赛 紫杉醇 

分 类 号：R734.2[医药卫生—肿瘤]