双环醇片防治肿瘤化疗药物性肝损害研究.docVIP

双环醇片防治肿瘤化疗药物性肝损害研究 　　[摘要] 目的：评价双环醇片对肿瘤化疗药物所致肝损害的治疗和预防作用。方法：随机选取62例初次肿瘤化疗后出现药物性肝损害的患者，开始口服双环醇片 50 mg 每日3次。待肝功能恢复正常后再次按照原方案化疗时，继续口服双环醇片50 mg 每日3次，持续14 d，前后进行自身对照。观察口服双环醇片对肿瘤患者化疗后肝损害所致谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（TBiL）等肝功能的影响。同时，观察口服双环醇片治疗肿瘤化疗药物所致肝损害恢复正常后，化疗同时联合双环醇片预防性保肝治疗，比较该次与单纯化疗前后的ALT、AST、TBiL差值。结果：口服双环醇片治疗化疗后肝损害，肝功能ALT、AST等指标明显降低，在中位时间8.5 d恢复正常。在预防化疗所致肝损害上，化疗与双环醇片联合治疗前后的ALT、AST差值明显减小，与单纯化疗前后比较，差异有统计学意义（P 　　[关键词] 双环醇片；化疗；防治；药物性肝损害 　　[中图分类号] R730.53 [文献标识码]A [文章编号]1674-4721（2011）06（b）-005-02 　　 　　Study of bicyclol in the prevention and treatment of hepatic damage caused by chemotherapy 　　ZENG Wucha, LIN Xuede, ZHANG Zhifeng, HUANG Yi, SHI Xi 　　Department of Chemotherapy, the First Affiliated Hospital of Fujian Medical University, Fujian Province, Fuzhou350005, China 　　[Abstract] Objective: To evaluate the efficacy of bicyclol in the prevention and treatment of hepatic damage caused by chemotherapeutic drugs． Methods: Sixty-twopatients with hepatic damage caused by chemotherapy were randomly chosen to receive bicyclol 50 mg tid orally after they were found hepatic damage caused by chemotherapeutic drugs． The influence of Bicyclol to ALT, AST, TBiL of cancer patients were observed after liver damage induced by Chemotherapy． After the recovery of the liver damage of these patients, the prophylactically protective effects of bicyclol to liver damage were also studied by combination cure of bicyclol and chemotherapy. Results: Bicyclol could obviously reduce the elevated ALT and AST level caused by chemotherapy. When used as a preventive medicine，combination cure of Bicyclol and Chemotherapy had protective effect to liver damage compared with Chemotherapy without Bicyclol(P0.05）。见表1。 　　2.2双环醇片对肿???化疗药物所致肝损害的预防作用 　　在预防化疗所致肝损害上，化疗与双环醇片联合治疗前后的ALT、AST差值明显减小，与单纯化疗比较差异有统计学意义（P0.05）。见表2。 　　3讨论 　　化疗是目前治疗恶性肿瘤的主要手段之一。在临床肿瘤化疗中，绝大多数抗肿瘤药物在杀伤和损害肿瘤细胞的同时，对正常组织细胞亦产生毒性作用和免疫抑制作用。这就是化学治疗产生毒副作用的基础。肝功能损害是化疗中常见的近期全身毒性反应之一。化疗药物引起肝脏损害的机制可能是：①药物及其中间代谢产物对肝脏的直接毒性作用；②机体对药物的变