恶性肿瘤化疗后肝功能异常的临床特征及其危险因素分析

Clinical features of abnormal liver function in cancer patients with chemotherapy and its related risk factors

目的探讨恶性肿瘤化疗后肝功能异常的临床特征及危险因素。方法选择住院治疗的309例恶性肿瘤化疗患者为研究对象,根据化疗后肝功能情况分为肝功能异常组123例、肝功能正常组186例;比较并分析肝功能异常的临床特征,并采用多因素logistic回归分析化疗后肝功能异常的影响因素。结果化疗后肝功能异常首次出现时间多数在化疗第1~4个周期,占96.7%。化疗所致肝功能异常不良反应分级以1级(69.9%)为主,肝损伤类型以肝细胞损伤型为主。肝功能异常患者因肝损伤延迟化疗占28.5%。多因素logistic回归分析显示,合并脂肪肝、高脂血症、肝脏转移是恶性肿瘤化疗后肝功能异常的危险因素(OR=2.410、1.756和2.182,均P<0.05),预防用药是保护因素(OR=0.551,P<0.05)。结论恶性肿瘤化疗患者合并脂肪肝、高脂血症、肝脏转移会增加化疗后肝功能异常发生的风险,而化疗期间预防用药可降低风险。

Objective To analyze the clinical features of abnormal liver function in cancer patients with chemotherapy and the related risk factors. Methods Three hundred and nine cancer patients receiving chemotherapy were enrolled in the study, among whom abnormal liver function was detected after chemotherapy in 123 cases and the remaining 186 cases had normal liver function. The clinical features of two groups were compared and the risk factors related to abnormal liver function was analyzed with multivariate Logistic regression.Results Most abnormal liver function was detected at the first to forth chemotherapy cycles（96.7%）. The chemotherapy was interrupted in 35cases（28.5%） due to abnormal liver function. Multivariate logistic regression analysis showed that fatty liver disease, hyperlipidemia and hepatic metastasis were the independent risk factors of abnormal liver function after chemotherapy（OR=2.410, 1.756 and 2.182, all P〈0.05）.The administration of hepatic protectants during chemotherapy was a protecting factor（OR=0.551, P〈0.05）. Conclusion The coexistence of fatty liver disease, hyperlipidemia and liver metastasis may increase the risk of abnormal liver function after chemotherapy in cancer patients,and the hepatic protectants may reduce this risk.