保肝药在雷替曲塞联合化疗中能否降低转氨酶的临床观察

目的:观察雷替曲塞联合化疗方案对晚期胃肠道肿瘤患者转氨酶的影响,探讨预防性给与第一周期后转氨酶异常患者保肝药治疗的必要性。方法:60例接受雷替曲塞(3 mg/m2)联合方案治疗的胃肠道肿瘤患者中第一周期后转氨酶异常的患者,在从第二周期开始给予保肝药预防为实验组(31例),未出现异常的不作预防性处理为对照组(29例)。结果:对照组未出现Ⅱ°以上转氨酶不良反应,实验组AST与ALT不良反应发生率明显高于对照组,分别为55.9%与20.1%、64.5%与24.1%,P<0.05,有统计学差异(χ2=10.162,P=0.001;χ2=9.191,P=0.002)。结论:预防性保肝药不能降低后续化疗引起的转氨酶异常发生率。

Clinical Observation of Transaminase in Patient Treated by Raltitrexed When Giving Preventive Hepatoprotectants

Objective： Toobserve the effects on transaminases by combination chemotherapy of raltitrexedin advanced gastrointestinal cancer and discuss the necessity of preventive use of hepatoprotectants. Meth-ods： A total of 60 patients treated with combination chemotherapy of raltitrexed were divided into twogroups based on the transaminase changes after one cycle, 31 patients as the experimental group weretreated with hepatoprotectants at the beginning of the second cycle since their transaminase activities wereover normal levels, and the others were put into the control group. Results： The control group had noaminotransferase reactions above grade 2, while those of the experimental group were apparently higher.The adverse effects rates were 55.9% and 20.1%, respectively, P〈0.05 （x2 AST=10.162, P=0.001; x2 ALT=9.191, P=0.002）. Conclusion： Preventive use of hepatoprotectants can not significantly made the transami-nase activities return to normal.