三氧化二砷治疗急性早幼粒细胞白血病的肝功影响因素及其转归

目的 了解三氧化二砷（As2O3)注射液对人肝功的影响及其转归，为合理，安全应用As2O3提供依据。方法 观察As2O3治疗前后，肝炎组与非肝炎组，饮酒组与非饮酒组，男性与女性肝功变化。结果 As2O3注射对肝功损伤率为16.16%，轻度，中度和重度损伤分别为75.0%,18.75%和6.25%。轻度和中度损伤者停砷剂，保肝治疗全部恢复，3例重度损伤者均有乙肝史，均死于肝功衰竭。结论 治疗剂量As2O3注射液对肝功的损伤较少见，且多为轻度，可逆的，但极少数为重度损伤，均死于肝功衰竭，其肝功损伤不仅与As2O3累积量呈正相关。也与饮酒，肝炎和男性等敏感因素有关。观察与处置应个体化。

Effect of the treatment with arsenic trioxide to the human liver function and their prognosis

Objective To investigate the effects of intravenous injection of arsenic trioxide(As 2O 3)to human liver function(LF).Methods The changes of LF were observed before and after treatment with As 2O 3 between hepatitis and non-hepatitis group,drinking and non-drinking group,male and female group respectively.Results Reaction of LF observed was 16.16%.Among them,mild,middle and severe reaction was 75.0%,18.75% and 6.25%.After stopping As 2O 3 and protective treatment,LF of mild and middle reaction cases were recovered.3 cases with severe reactions had a history of hepatitis dying of hepatocellular failure(HF).The relation of LF reaction was not only to accumulation amount of As 2O 3 but also to drinking,hepatitis and male.Conclusions Little reaction was observed in allotting dosage treatment with As 2O 3,most of which was mild and reversible.Few cases with severe reaction died of HF.The degree of injured LF was not only related to accumulation amount of As 2O 3positively,but also to the drinking,hepatitis and male.We think the treatment should be done individually.