肺癌患者化疗后药物性肝损伤的临床特点

Clinical Characteristics of Drug-induced Liver Injury after Chemotherapy in Lung Cancer Patients

目的 探讨肺癌患者化疗后药物治疗过程中所致药物性肝损伤的临床特点。方法 采用回顾性分析法,分析总结我院于2017年1月至2019年6月收治的160例肺癌患者的临床资料。统计分析患者的性别、年龄、原发性肿瘤类型、肝功能、肝损伤发生时间、保肝药物应用情况等。分析对患者实施DP方案、EP方案、GP方案所产生药物性肝损伤情况及愈后。结果 3种化疗方案的肝损伤严重程度均发生在1级和2级,经检验3种方案所致的药物性肝损伤发生率对比,差异有统计学意义,P <0.05。DP方案患者肝细胞损伤类型以胆汁淤积型为主,GP方案患者肝细胞损伤类型以肝细胞损伤型为主,EP方案患者肝细胞损伤类型以混合型为主。不同化疗方案所致患者药物性肝损伤后,对患者进行针对性药物治疗患者均好转或治愈,但差异无统计学意义,P> 0.05。结论 3种不同肺癌化疗中,GP方案所致的患者化疗后药物性肝损伤发生率最高,EP方案、DP方案的肝损伤均存在不同特点。在临床治疗中需充分考虑并对症使用保肝类药物,以提升患者的治疗效果。

Objective To investigate the clinical characteristics of drug-induced liver injury in patients with lung cancer after chemotherapy.Methods The clinical data of 160 patients with lung cancer admitted to our hospital from January 2017 to June 2019 were analyzed and summarized by retrospective analysis.The patient’s gender,age,primary tumor type,liver function,time of liver injury,and application of hepatoprotective drugs were analyzed.To analyze the situation of drug-induced liver injury caused by the implementation of DP scheme,EP scheme and GP scheme.Results The severity of liver injury of the three chemotherapy regiments occurred in grade 1 and grade 2,and the differences in the incidence of drug-induced liver injury caused by the three chemotherapy regiments were statistically significant(P<0.05).The type of hepatocyte injury in patients with DP regimen is mainly cholestatic type,the type of hepatocyte injury in patients with GP regimen is mainly the type of hepatocyte injury,the type of hepatocyte injury in patients with EP regimen was mainly mixed type.After drug-induced liver injury caused by different chemotherapy regimentation,all patients who received targeted drug therapy improved or cured,but there was not statistically significant(P>0.05).Conclusion Among the three kinds of chemotherapy for lung cancer,the incidence of drug-induced liver injury after chemotherapy was the highest in patients caused by GP regimen,and the liver injury in EP regimen and DP regimen had different characteristics.Therefore,liver protection drugs should be fully considered and applied in clinical treatment to improve the therapeutic effect of patients.