恶性血液肿瘤患者化学治疗相关肝损伤防治现状

Occurrence and prevention of chemotherapy induced liver injury in patients with hematologic malignancy

目的:讨论恶性血液肿瘤患者化学治疗(化疗)相关的肝损伤防治现状。方法 :回顾分析2 066例血液肿瘤患者化疗前后肝功能的相关资料,根据既往有无肝脏疾病进行分类,并比较化疗中有无合并保肝治疗的肝功能差异。结果:化疗前既往有肝脏疾病史的患者肝功能异常的比例较高(37.42%);化疗后大部分(83.79%)患者肝功能保持正常或维持于治疗前水平,化疗前肝功能正常患者化疗后仍保持较好的肝功能,而化疗前存在肝损伤的患者化疗后肝功能仍较正常组差;保肝治疗能显著减少肝损伤发生(P<0.01)。结论:有效预防和治疗化疗引起的药物性肝损伤,对于需要多次化疗的血液肿瘤患者具有重要意义。

Objective To analyze the liver injury caused by chemotherapy in patients with hematologic malignancy.Methods The relevant data of liver function before and after chemotherapy in 2 066 patients with hematologic malignancy were analyzed retrospectively,and to compair the liver function between patients with and without liver protective therapy in chemotherapy. Results Patients having a history of liver diseases had a high incidence of abnormal liver function before chemotherapy（37.42%）. However,most of the patients（83.79%） can maintain their original hepatic function after chemotherapy. Liver protective therapy could reduce the incidence of liver injury（P0.01）. Conclusions Liver protective therapy is important for patients with hematologic malignancy requiring multiple courses of chemotherapy.