与甘露消毒丸相关的泌尿系肿瘤十例分析

目的:探讨与服用甘露消毒丸相关的泌尿系肿瘤患者的临床病理特点.方法:分析长期服用甘露消毒丸并存在泌尿系恶性肿瘤的10例患者的临床病理特点,并比较服药导致的尿毒症患者与同期住院的其他尿毒症患者的肿瘤发生率.结果:10例患者主要表现为反复发作的全程均一性肉眼血尿,病理检查确诊为泌尿系移行上皮细胞癌:7例膀胱癌、2例肾盂癌及1例肾盂输尿管癌,都伴慢性间质性肾炎,9例患者处于尿毒症终末期,1例肾功能正常.服药人群的肿瘤发生率明显高于普通尿毒症组(分别为32.1%和2.6%),差别有高度统计意义(P＜0.001).结论:长期服用甘露消毒丸者泌尿系恶性肿瘤发生率高,可能与其中所含的马兜铃酸成分有关.对存在正常形态血尿的服药患者,尤其是合并慢性间质性肾炎患者,必须高度警惕肿瘤可能.

Analysis of carcinoma of urinary system in relation to Ganluxiaoduwan (Chinese herb) in 10 cases

Objective:To explore the clinical and pathological characteristics of 10 cases suffered from carcinoma of the urinary system in relation to taking for long time Ganluxiaoduwan contained Caulis Aristolochiae Manshuriensis.Methods:The clinicopathological characteristics of the urinary carcinoma affected by taking Ganluxiaoduwan containing Caulis Aristolochiae Manshuriensis was analyzed in 10 patients. The incidence of carcinoma in uremic patients taken the drug was compared with other inpatient with uremia.Results:The main manifestations were recurrent homogenous macroscopic hematuria in the whole courses of diseases in 10 patients. The diagnosis of them was proven to be transitional cell carcinoma nephritis through pathological examination.Of which, 7 cases were papillary bladder carcinoma, 2 cases carcinoma of the renal pelvis, and 1 case carcinoma in the ureter and renal pelvis. All of them accompanied with chronic interstitial nephritis. Nine cases were in the terminal stage of uremia, while one case had normal renal function. The incidence of carcinoma of the uremic patient taken the drug chronically was obviously higher than that of the other inpatient with uremia (32.1% and 26%, respectively). The difference had predominant statistical significance (P<0.01).Conclusion:Taking Ganluxiaoduwan for long time may lead to transitional cell carcinoma. Aristolochic acid contained in it is the main reason. Should be on guard against the probability of carcinoma in patients with normal morphological hematuria, especially those with chronic interstitial nephritis.