含紫杉醇联合方案引起肝功能异常的临床分析

CLINICAL ANALYSIS OF LIVER FUNCTIONAL LESION CAUSED BY COMBINATION CHEMOTHERAPY CONTAINING PACLITAXEL

目的 观察含紫杉醇联合化疗方案对肿瘤患者肝功能的影响,以及化疗后肝损害的特点及易感因素.方法 对2008年1月～2010年12月间32例含紫杉醇联合化疗方案化疗后出现药物性肝功能异常的恶性肿瘤患者,统计分析化疗前后谷丙转氨酶（ALT）,谷草转氨酶（AST）,碱性磷酸酶（ALP）,总胆红素（TBIL）等指标的变化.结果 共收治肿瘤患者3 327例,化疗后发生肝功能异常患者101例,占所有肿瘤患者的3.04%.101例发生肝功能异常的患者中,32例为以紫杉醇为主的联合化疗方案,占所有发生肝功能异常患者的31.68%.化疗后ALT、AST、ALP指标显著高于化疗前（p〈0.05）,肝功能损害大多数出现在化疗前5个周期,多为Ⅰ～Ⅱ.年龄、性别、携带乙肝病毒、肿瘤类型、分期等相关因素对肝功能无明显影响（p〉0.5）.结论 紫杉醇引起药物性肝损害临床常见,肝损害以轻度损伤为主,年龄、性别、携带乙肝病毒、肿瘤类型、分期等相关因素对肝功能无明显影响.

Objective To observe liver functional lesion caused by combination chemotherapy containing pa- clitaxel, and the characteristics and risk factors of hepatotoxicity. Methods Data from 32 patients with liver function- al lesion caused by chemotherapy containing paclitaxel between January 2008 and December 2010 were analyzed. Liv- er functions of ALT, AST, ALP and TBIL were studied. Results Toltally 101 patients with liver functional lesion caused by chemotherapy, 32 caused by combination chemotherapy containing paclitaxel, the incidence rate was 31.68%. Liver functions of ALT,AST, ALP after chemotherapy were significantly higer than that befor chemotherapy （p 〈 0.05 ）. Most of them appeared in the previous five cycles and most of the hepatic injuries were in Grade 1/2. Relative factors of age, sex, hepatitis B virus, types of cancers were not significantly associated with chemotherapy hep- atotoxicity. Conclusion Liver functional lesion caused by paclitaxel is quite common in clinical and most are milde. Relative factors of age, sex, hepatitis B virus, types of cancers were not significantly associated with chemotherapy hepatotoxicity.