氨磷汀对恶性肿瘤化疗患者肝脏保护作用的临床观察

Observation on amifostine for the protection of hepatic toxicity in malignant tumor chemotherapy patients

目的探讨氨磷汀对恶性肿瘤化疗患者的肝脏保护作用。方法选取100例既往化疗出现药物性肝损害的恶性肿瘤患者,采用随机数字表法分为研究组与对照组,每组患者各50例,研究组在化疗前接受氨磷汀单药治疗,对照组自化疗开始进行7 d的异甘草酸镁治疗,两组患者均在化疗前1天、化疗第10天复查血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、总胆红素(TBIL)指标检测肝功能情况。结果研究组肝功能损害发生12例(24.0%),对照组则为28例(56.0%),两组间差异有统计学意义(χ~2=10.667,P=0.001)。患者化疗后10 d研究组、对照组肝功能指标ALT、AST,差异有统计学意义(P=0.038,P=0.013),而化疗后两组ALP、TBIL差异无统计学意义(P=0.907,P=0.248)。结论化疗前使用氨磷汀,可在一定程度上降低药物性肝功能损害发生率,提高化疗安全性。

Objective To observe the protection of hepatic toxicity by amifostine in malignant tumor patients receiving chemotherapy. Methods 100 cases had history of drug-induced liver injury were randomly divided into experimental group and control group. There were 50 cases in each group. The experimental group received amifostine before chemotherapy,while the control group received 7 days magnesium isoglycyrrhizinate from the beginning of chemotherapy.All patients were examined before chemotherapy and 10 days after therapy,including liver function markers of ALT,AST,ALP and TBIL. Results The incidence of liver damage in experimental group and the control group were 12（ 24. 0%） and 28（ 56. 0%）,respectively. The difference was statistically significant between the two groups（ χ^2=10. 667,P = 0. 001）. ALT,AST,ALP,TBIL were detected 10 days after chemotherapy. The experimental group＇ s ALT and AST are statistically lower than those in control group（ P = 0. 038,P = 0. 013）. But there was no significant difference btween experimental group and control group about ALP and TBIL（ P = 0. 907,P = 0. 248）. Conclusion Amifostine is effective in protecting the injury of hepatic function caused by chemotherapy.