硫普罗宁干预治疗化疗引起的白细胞减少及肝功能损伤临床研究

硫普罗宁干预治疗化疗引起的白细胞减少及肝功能损伤临床研究 硫普罗宁干预治疗化疗引起的白细胞减少及肝功能损伤临床研究 【摘要】 目的 探讨硫普罗宁静滴干预治疗肿瘤化疗引起的白细胞减少及肝功能损伤疗效与不良反应。方法 对确诊并需执行全身化疗或灌注化疗的166例肿瘤患者，在化疗前或化疗执行同时，静脉滴注凯西莱，每日1次，每次0.1,0.4 g，7,14天为1个疗程，观察化疗前后白细胞减少情况、肝功能损伤(异常)情况、生存质量及不良反应情况，与对照组160例未做干预治疗的化疗患者比较分析。参照 Karnofsky评分(Kps)评价生存质量(QOL)，按照NCICTC3.0版标准评价不良反应。结果 治疗组166例中，化疗后新增白细胞减少?,?度36例(2 1.69%)，?,?度12例(7.23%)，肝功损伤(新增或加重)16例(9.64%)。Kps评分下降22例(13.25%)，提高99例(59.64%)。相关不良反应只有3例( 1.81%)为轻度皮炎。对照组160例中，化疗后白细胞减少?,?度72例 (45.00%)，?,?度24例(15.00%)，肝功损伤(新增或加重)36例 (22.50%)。Kps评分下降55例(34.38%)，提高仅20例(12.50%),χ2检验P值分别为:0.00 1、0.02 5、0.00 2、0.00 1、0.001。结论 凯西莱干预治疗肿瘤化疗引起的白细胞减少及肝功能损伤有显着 疗效，同时能提高生存质量，未发现严重的不良反应。 【关键词】 凯西莱 干预治疗 肿瘤化疗 白细胞减少/肝功损伤 生存质量 Clinical study on leukopenia and liver function injury induced by intervention chemotherapy with Tiopronin ,Abstract, Objective To explore curative effect and side effect of Tiopronin in intervention chemotherapy inducing leukopenia and liver function injury in patients with carcinoma.Methods There were 166 patients who were diagnosed and accepted systemic or perfusion chemotherapy in therapy group,Tiopronin was used in patients before and after chemotherapy,once daily，it was 0.1,0.4 g every time,it was 7,14 d a treatment course.It was observed for leukopenia and liver function injury and condition of survival and side effect before and after chemotherapy.it was not used by Tiopronin for carcinoma patients who accepted chemotherapy in control group.Evaluation of survival quality was consulted by Karnofsky(Kps).Evaluation of toxicity response was consulted by NCICTC 3.0 version.Results There were 36 patients in therapy group(2 1.69 percent),whose new enhance leukopenia was ?,?degree,there were 12 patients whose new enhance leukopenia was ?,? degree(7.23 percent).There were 16 patients who had liver function injury(new enhance or aggravation )(9.64 percent),there were 22 patients whose Kps evaluation decreased(13.25 percent),it were 99 patients whose Kps evaluation improved(59.64 percent),it was only 3 patients who existed relatively toxicity response,they were mild dermatitis.But there were 72 patients in therapy group(45.00 percent),whose new enhance leukopenia was ?,?degree,it was 24 patients whose new enhance leukopenia was ?,? degree(15 percent).it was 36 patients who had liver function injury(new enhance or aggravation )(22.50 percent),it was 55 patients whose Kps evaluation had decreased(34.38 percent),it was 20 patients whose Kps evaluation improved(12.50 percent).Conclusion There has significant curative effect for Tiopronin in intervention chemotherapy inducing leukopenia and liver function injury in patients with carcinoma,it advances survival quality for patients,without serious toxicity response. ,Key words, Tiopronin;intervention;carcinoma chemotherapy;leukopenia/liver function injury;survival quality 肿瘤化疗发生相关的并发症中，白细胞减少及肝功能损害发生比例较高,1,，直接影响患者的生命及生存质量(QOL)，同时也影响到化疗的连续执行,2,。如果白细胞减少或肝 功损伤后再用药，往往所需时间延长，影响患者康复,3,，本组系用硫普罗宁(凯西莱)提早或与化疗同步干预治疗，初显成效，现分析如下。 1 资料与方法 1.1 一般资料 治疗组166例中;男100例，女66例，最大年龄83岁，最小16岁，平均56岁;胃癌41例，肺癌30例，结直肠癌24例，食管癌10例，肝癌15例，乳腺癌15例，恶性淋巴瘤15例，鼻咽癌10例，卵巢癌6例。对照组160例中，男95例，女65例;最大年龄79岁，最小18岁;胃癌30例，肺癌32例，结直肠癌22例，食管癌8例，肝癌15例，乳腺癌16例，恶性淋巴瘤16例，鼻咽癌11例，卵巢癌5例。两组对照差异无统计学意义(P,0.05)。两组病例均为化疗病 例，除肝癌为动脉插管灌注化疗及卵巢癌部分药物行腹腔灌注化疗外，其余均行静脉全身化疗，方案为现行公认的标准方案或二线方案,4,，新药试验未列在本组研究范围。