血脂异常对乳腺癌患者首次化疗后肝功能的影响

目的 分析血脂异常对乳腺癌患者首次化疗后肝功能的影响。方法 收集首次接受化疗的乳腺癌患者 814例，根据患者首次化疗前血脂情况分为血脂异常组（n=456）和血脂正常组（n=358），比较2组间化疗后肝功能异 常发生情况；根据首次化疗前血脂情况将化疗后肝功能异常的患者（n=268）分为混合性血脂异常组（n=16）、非混合 性血脂异常组（n=157）和血脂无异常组（n=95），比较3组间化疗后丙氨酸转氨酶（ALT）水平；根据化疗前后各血脂指 标变化情况分为血脂不平稳组（n=723）和血脂平稳组（n=91），比较化疗后ALT水平。结果 血脂异常组和血脂正常 组年龄、体质量指数、手术史、化疗方案、联合曲妥珠单抗及首次化疗前ALT水平比较差异均无统计学意义。与血脂 正常组相比，血脂异常组首次化疗前总胆固醇、三酰甘油和低密度脂蛋白胆固醇水平均显著升高，高密度脂蛋白胆 固醇水平显著降低（P＜0.01）。血脂异常组化疗后肝功能异常的发生率较高（P＜0.01）。混合性血脂异常组患者化 疗后ALT水平明显高于非混合性血脂异常组及血脂无异常组（P＜0.05）。血脂不平稳组患者化疗后ALT水平明显高 于血脂平稳组（P＜0.05）。结论 存在血脂异常的乳腺癌患者化疗后更易出现肝功能异常。

The effect of dyslipidemia on liver function after the first chemotherapy in breast cancer patients

Objective To analyze the effect of dyslipidemia on the liver function after the first chemotherapy in breast cancer patients. Methods A total of 814 patients with breast cancer in our hospital were collected. Patients were divided into the dyslipidemia group (n=456) and the normal blood lipid group (n=358) according to their blood lipid before the first chemotherapy. The occurrence of abnormal liver function after the chemotherapy was compared between the two groups. According to blood lipids before chemotherapy, patients with abnormal liver function after chemotherapy (n=268) were divided into the mixed dyslipidemia group (n=16), the non-mixed dyslipidemia group (n=157) and the normal lipid group (n= 95). The alanine transaminase (ALT) levels after chemotherapy were compared between the three groups. According to the changes of blood lipid indexes before and after chemotherapy, all the patients were divided into the unstable blood lipid group (n=723) and the stable blood lipid group (n=91). The ALT levels after chemotherapy were compared between the two groups. Results There were no significant differences in age, body mass index (BMI), surgical history, chemotherapy regimen, and combined trastuzumab and ALT level before the first chemotherapy between the dyslipidemia group and the normal lipidemia group. Compared with the normal group, the levels of total cholesterol (TC), triglyceride (TG) and low density lipoprotein (LDL-C) were significantly increased in the dyslipidemia group, while the levels of high density lipoprotein (HDL-C) were significantly decreased (P＜0.01). The incidence of abnormal liver function after chemotherapy was higher in the dyslipidemia group (P＜0.01). After chemotherapy, the ALT level was significantly higher in the mixed dyslipidemia group than that in the non-mixed dyslipidemia group and the no dyslipidemia group (P＜0.01). After chemotherapy, the ALT level was significantly higher in the unstable blood lipid group than that in the stable blood lipid group (P＜0.05). Conclusion Breast cancer patients with lipid metabolism disorders are more likely to develop liver dysfunction after chemotherapy.