新辅助化疗药物对乳腺癌患者肝功能及外周血常规的影响

Effects of neoadjuvant chemotherapy on liver function and peripheral hemogram in patients with breast cancer

目的探讨新辅助化疗药物对乳腺癌患者肝功能及外周血常规的影响及其动态变化规律的临床意义。方法回顾性分析乳腺癌患者行新辅助化疗前后肝功能及外周血常规指标,并对化疗前后的各项指标进行比较分析。结果与化疗前比较,化疗后总胆汁酸、谷丙转氨酶异常率明显增加,总胆汁酸由化疗前的10.3%增加至第4周期的27.1%(χ^2=14.823,P=0.005),谷丙转氨酶由化疗前的2.9%增加至第4周期的18.6%(χ^2=9.615,P=0.047)。与化疗前比较,化疗后红细胞、血红蛋白、血小板、淋巴细胞、单核细胞异常率明显增加,红细胞异常率由化疗前的3.0%增加至第4周期的28.8%(χ^2=49.006,P<0.001),血红蛋白异常率由化疗前的22.4%增加至第4周期的57.6%(χ^2=26.681,P<0.001),血小板异常率由化疗前的22.4%增加至第4周期的52.5%(χ^2=27.580,P<0.001),淋巴细胞异常率由化疗前的3.0%增加至第4周期的20.3%(χ^2=16.248,P=0.003),单核细胞异常率由化疗前的11.9%增加至第4周期的32.2%(χ^2=20.092,P<0.001)。结论新辅助化疗药物在预防性保肝治疗下仍有部分乳腺癌患者发生肝损伤,同时可引起乳腺癌患者外周血常规指标异常,应引起医生和患者的重视。尤其对于贫血患者,应予以适当营养支持和治疗以改善患者的生活质量和提高化疗效果。

Objective To investigate the effects of neoadjuvant chemotherapy on liver function and peripheral blood hemogram in patients with breast cancer and its clinical significance.Methods The indexes of liver function and peripheral blood hemogram of breast cancer patients before and after chemotherapy were retrospectively collected,and then analyzed and compared.Results Compared with before chemotherapy,the abnormal rate of total bile acid and alanine transaminase increased significantly after chemotherapy.The abnormal rate of total bile acid increased from 10.3%before chemotherapy to 27.1%in the fourth cycle(χ^2=14.823,P=0.005),and the abnormal rate of alanine transaminase increased from 2.9%before chemotherapy to 18.6%in the fourth cycle(χ^2=9.615,P=0.047).Compared with before chemotherapy,the abnormal rate of red blood cell,hemoglobin,platelet,lymphocyte and monocyte after chemotherapy increased significantly.The abnormal rate of red blood cell increased from 3.0%before chemotherapy to 28.8%in the fourth cycle(χ^2=49.006,P<0.001),the abnormal rate of hemoglobin increased from 22.4%before chemotherapy to 57.6%in the fourth cycle(χ^2=26.681,P<0.001),the abnormal rate of platelet increased from 22.4%before chemotherapy to 52.5%in the fourth cycle(χ^2=27.580,P<0.001),the abnormal rate of lymphocyte increased from 3.0%before chemotherapy to 20.3%in the fourth cycle(χ^2=16.248,P=0.003),the abnormal rate of monocyte increased from 11.9%before chemotherapy to 32.2%in the fourth cycle(χ^2=20.092,P<0.001).Conclusion Neoadjuvant chemotherapy drugs can cause liver damage of some breast cancer patients in the preventive treatment,at the same time cause abnormalities in peripheral blood of breast cancer patients,which should be paid attention to by doctors and patients.Especially for related anemia patients,appropriate nutritional support and related treatment should be provided to improve the quality of life and chemotherapy effect of patients.