应用卡铂联合化疗患者的肾功能变化

The Effect of Carboplatin Combined Chemotherapy on Renal Function in Patients with Ovarian Carcinoma

目的观察应用卡铂联合化疗过程中患者肾功能的变化。方法选择术后接受卡铂联合化疗方案的卵巢癌患者７例，共观察２６个疗程。于化疗中每周应用彩色多普勒超声仪监测患者肾脏血流，测定肾脏中心区域的区域动脉、叶间动脉的血流速度波形，求得收缩期最高血流速度（Ｖｍａｘ），扩张期最低血流速度（Ｖｍｉｎ）及阻力指数。同时对１４例正常妇女测定以上相应指标（对照组）。结果化疗第１～３周，肾血流速度与对照组比较下降显著（Ｐ＜０．０１）；肌酐清除率（Ｃｃｒ）随扩张期Ｖｍｉｎ下降而显著下降（ｒ＝０．５２，Ｐ＜０．０１）。结论应用卡铂联合化疗，可引起肾功能障碍。肾脏血流速度能反映肾功能变化，可作为一项监测指标。

Objective To investigate the changes of renal function during carboplatin (CBDCA) combined chemotherapy in patients with ovarian carcinoma. Methods 26 courses of postoperative systemic CBDCA therapy were carried out in 7 patients with ovarian carcinoma. During chemotherapy both systolic maximum and diastolic minimum blood flow velocity (Vmax, Vmin) and resistance index (RI) in renal segmental artery (SA) and interlobular artery (ILA) were meaured by color doppler weekly. Meanwhile renal creatinine clearance rate (Ccr) were also determined. 14 healthy women were taken as controls. Results From the 1st week to the 3rd week at the begining of CBDCA therapy, Vmax and Vmin in SA and ILA were significantly decreased ( P <0.01). A significant positive correlation was found between Ccr and the values of Vmin in SA and ILA ( r=0.52, P<0.01 ). Conclusions The results indicated that carboplatin combined chemotherapy could induce disturbances of renal function. The changes of renal function were related to renal blood flow velocity which could be used as a monitoring index of renal function.