摘要
目的探讨N-乙酰半胱氨酸（NAC）注射液对老年患者以顺铂为主的联合化疗所导致肝肾损害的改善作用。方法40例接受肿瘤化疗的老年患者随机自身交叉分为AB和BA组，AB组第1周期为化疗加NAC治疗10d，第2周期为化疗加肌苷、维生素C注射液10d；BA组第1周期为化疗加肌苷、维生素C注射液治疗10d，第2周期为化疗加NAC治疗10d，每21天为1个周期。观察比较两组患者肝肾损害程度的差异，并评价NAC治疗肝肾损害的疗效。结果A周期化疗后血清丙氨酸氨基转移酶（ALT）水平（29．18±5．43）U／L、门冬氨酸氨基转移酶（AST）水平（32．37±7．13）U／L、肌酐（95．22±20．60）／μmol／L，与化疗前[分别为（25．32±5．23）U／L、（29．21±6．51）U／L和（89．87±19．56）μmol／L]比较，差异均无统计学意义（均为P〉0．05）；B周期化疗后ALT（56．76±5．53）U／L、AST（48．83±6．64）U／L和肌酐（137．33±21．16）μmol／L，较化疗前[分别为（26．19±5．51）U／L,（29．95±6．56）U／L和（88．66±18．27）μmol／L]均增高（均为P〈0．01）。结论NAC对老年患者化疗所致肝肾功能损害有明昂保护作用，可防治化疗所砷的肝肾功能损害．
Objective To evaluate the effect of N-acetylcysteine （NAC） on alleviating hepatorenal damage caused by combined chemotherapy using cisplatin-based regiments in elderly patients. Methods All 40 elderly patients with malignant tumors were randomly divided into AB and BA group in cross-over pattern. In AB group, combination of chemotherapy and NAC was administrated for 10 days first, and then combination of chemotherapy, earnine and vitamin C was given for 10 days. In BA group, combination of chemotherapy, carnine and vitamin C was administrated for 10 days first, and then combination of chemotherapy and NAC was given for 10 days, a cycle was 21 days. The hepatorenal damage degree was observed and the curative effect of NAC on hepatorenal damage was evaluated. Results There were no differences in the levels of alanine aminotransferase（ALT）, aspartate aminotransferase（AST） and serum creatinine（Cr） between pre chemotherapy and post chemotherapy in A cycle [（25. 32±5. 23） U/L vs. （29. 18±5.43） U/L, （29. 21±6. 51）U/L vs. （32.37±7. 13 ）U/L, （89.87±9.56）μmol/L vs. （95.22±20.60）μmol/L, all P〉0. 05]. In B cycle, the levels of ALT,AST and Cr were （56. 76±5.53） U/L, （48.83±6.64） U/L and （ 137.33 ±21.16）μmol/L post chemotherapy, respectively, which were evidently higher than pre chemotherapy [（ 26. 19 ± 5.51 ） U/L, （ 29.95 ± 6.56 ） U/L and （ 88.66 ± 18.27 ） μmol/L, respectively]（ all P〈0.01） . Conclusions NAC has better preventive and therapeutic effects on hepatorenal damage caused by the chemotherapeutic drugs in elderly patients with malignant cancer.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2009年第8期668-670,共3页
Chinese Journal of Geriatrics
关键词
乙酰半胱氨酸
药物疗法
联合
肝功能不全
肾功能不全
Acetylcysteine
Drug therapy, combination
Hepatic insufficiency
Renalinsufficiency
