乳腺癌病人高剂量顺铂治疗的肾毒性监测指标比较

COMPARISON OF INDICES OF MONITORING NEPHROTOXICITY WITH HIGH DOSE CIS-PLATINUM IN BREAST CANCER PATIENTS

本文对３３例乳癌病人的６０次高剂量ＰＤＤ（９０—１００ｍｇ／ｍ２）化疗进行了肾毒性的观察。结果显示尿ＡＬｂ、ＩｇＧ、ＮａＧ能较敏感地反映肾毒性，这三项指标均以ＰＤＤ疗后第４—７天升高最为明显，其异常发生率分别为９１．６％、８０．０％、８５．０％。疗后１４天大部分患者恢复到正常水平。尿蛋白定性检查及血清ＢＵＮ、Ｃｒ也能反映ＰＤＤ肾毒性，但敏感性显著低于前者，异常率分别为３０．５％及４．０％、８．Ｏ％。本文材料表明尿ＡＬｂ、ＩｇＧ、ＮＡＧ可望成为临测ＰＤＤ肾毒性的理想指标。

Six indices including urinary Alb,IgG,NAG,protein qualitative analysis.serum BUN and Cr weremeasured in 33 patients with breast cancer who received 60 cycles of high dose cisplatinum (90 100mg/m2)to evaluate the sensitivity of these indices。 Results showed that values of urinary Alb,IgG and NAGmarkedly increased above normal level during 4-7 days after PDD treatment and abnormal rates were91.6%,80.0%,and 85.0%,respectively。 At the same time, abnormal rates of serum BUN,cr andurinary protein qualitative analysis were 4. 0%～8.0%and 30.0%,respectively,and their sensitivitieswere much lower than the former.Our results suggested that urinary ALb,IgG and NAG may be ideal in-dices for monitoring nephrotoxicity of cis-platinum。