乳腺癌术后三苯氧胺致脂肪肝36例分析

Tamoxifen-induced fatty liver in postoperative patients with breast cancer:an analysis of 36 cases

目的：分析口服三苯氧胺导致脂肪肝的CT表现和发生机制，提高对三苯氧胺治疗乳腺癌不良反应的认识。方法：回顾性分析36例乳腺癌术后口服三苯氧胺致脂肪肝患者的CT及临床资料。结果：36例脂肪肝患者中，轻度脂肪肝20例（55．5％），中度脂肪肝11例（30．6％），重度脂肪肝5例（13．9％）；以CT表现分型：弥漫性脂肪肝31例（86．1％），局灶性脂肪肝5例（13．9％）；治疗过程中36例患者有6例（16．7％）出现转氨酶升高，其中4例停药后复查，肝功能均正常；8例停药后复查的脂肪肝患者中6例好转，2例恢复正常。结论：苯氧胺可诱导脂肪肝的发生，以轻度弥漫性脂肪肝最为多见，临床医生应认识到这种副作用，早期诊断．及时治疗。

Objective To explore the CT findings and mechanism of tamoxifen-induced fatty liver, and to broaden the knowledge of adverse reactions of tamoxifen for breast cancer. Methods The clinical data and CT findings of 36 patients with fatty liver caused by oral tamoxifen were analysed retrospectively. Results 20 patients （55.5%） had mild fatty liver, 11 （30.6%） had moderate, and 5 （13.9%） had severe. On CT imaging, diffuse type was in 31 patients （86.1%） and focal type in 5 （13.9%）. Aminotransferase levels elevated in 6 of 36 patients （16.7%） during the therapy, bot retorned to normal in 4 after discontinuation of tamoxifen. Fatty liver alleviated in 6 patients disappeared in 2 after discontinuation of tamoxifen. Conclusions Tamoxifen can induce the development of fatty liver and mild diffilse fatty liver is most common one. Clinicians should know the side effect of tamoxifen and diagnose and treat it as early as possible.