摘要
目的研究复方苦参注射液治疗后肺癌化疗患者肾毒性的影响因素及血清肌酐(SCr)预测肾毒性的应用价值。方法回顾性分析2020年5月至2022年5月收治于上饶东信第五医院的60例肺癌化疗患者的临床资料,所有患者均予以复方苦参注射液治疗,根据肾毒性发生情况,将患者分为肾毒性组(n=19)和非肾毒性组(n=41),采用logistic回归分析导致肺癌化疗患者发生肾毒性的独立危险因素,绘制ROC曲线评估SCr监测复方苦参注射液在缓解肺癌化疗患者肾毒性的应用价值。结果单因素分析结果显示,肾毒性组患者的体重指数(BMI)<18.5 kg/m2、合并基础疾病、顺铂为主要化疗药物、顺铂/卡铂化疗周期≥4个周期占比高于非肾毒性组,差异有统计学意义(P<0.05);肾毒性组患者的SCr、血尿素氮(BUN)、血尿酸(SUA)指标水平高于非肾毒性组,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,合并基础疾病(β=1.247,OR=3.480,95%CI=1.601~7.562)、顺铂化疗(β=1.522,OR=4.581,95%CI=1.330~15.780)、SCr(β=1.198,OR=3.313,95%CI=1.801~6.096)是肺癌化疗患者肾毒性的独立危险因素(P<0.05)。SCr变化倍率预测复方苦参注射液缓解化疗肺癌患者肾毒性的AUC为0.865,95%为0.752~0.940,敏感度为84.21%,特异度为85.37%,最佳截断值为1.2。结论合并基础疾病、顺铂化疗、入院时基础SCr水平过高是复方苦参注射液治疗后肺癌化疗患者发生肾毒性的独立危险因素,SCr变化倍率对评价复方苦参注射液在缓解肺癌化疗患者肾毒性的临床效果具有重要价值,化疗期间需进行SCr监测以保证用药安全。
Objective To study the influencing factors of nephrotoxicity in patients with lung cancer chemotherapy after Compound Kushen Injection and application value of serum creatinine(SCr)on predicting nephrotoxicity.Methods Retrospective analysis was performed on the clinical data of 60 patients with lung cancer treated with chemotherapy in Dongxin Fifth Hospital of Shangrao City from May 2020 to May 2022.All patients were treated with Compound Kushen Injection.According to the occurrence of nephrotoxicity,the patients were divided into nephrotoxicity group(n=19)and non-nephrotoxicity group(n=41).Independent risk factors of nephrotoxicity in patients with lung cancer chemotherapy were analyzed by logistic regression analysis,and ROC was drawn to evaluate the application value of SCr monitoring of Compound Kushen Injection on alleviating the nephrotoxicity in patients with lung cancer chemotherapy.Results Univariate analysis showed that the proportions of patients with body mass index(BMI)<18.5 kg/m2,underlying diseases,cisplatin as the main chemotherapy drug and cisplatin/carboplatin chemotherapy≥4 cycles in nephrotoxicity group were higher than those in non-nephrotoxicity group,the differences were statistally significant(P<0.05).The levels of SCr,blood urea nitrogen(BUN)and serum uric acid(SUA)were higher in nephrotoxicity group than those in non-nephrotoxicity group,the differences were statistally significant(P<0.05).Multivariate logistic regression analysis showed that the presence of underlying diseases(β=1.247,OR=3.480,95%CI=1.601-7.562),cisplatin chemotherapy(β=1.522,OR=4.581,95%CI=1.330-15.780)and SCr(β=1.198,OR=3.313,95%CI=1.801-6.096)were independent risk factors for nephrotoxicity in patients with lung cancer chemotherapy (P<0.05). The AUC, 95%CI, sensitivity, specificity and optimal cut-off value of SCr variation rate on predicting nephrotoxicity alleviated by compound Kushen injection in patients with lung cancer chemotherapy were 0.865, 0.752-0.940, 84.21%, 85.37% and 1.2 respectively. Conclusion Presence of underlying disease, cisplatin chemotherapy and high basic SCr level before chemotherapy are independent risk factors of nephrotoxicity in patients with lung cancer chemotherapy after compound Kushen injection. The variation rate of SCr has important value on evaluating the clinical effects of Compound Kushen Injection on alleviating nephrotoxicity in patients with lung cancer chemotherapy. It is necessary to conduct SCr monitoring during chemotherapy to ensure drug safety.
作者
洪星
李康
HONG Xing;LI Kang(Department of Laboratory Medicine,Shangrao Dongxin Fifth Hospital,Jiangxi Province,Shangrao334000,China)
出处
《中国当代医药》
CAS
2023年第34期106-109,114,共5页
China Modern Medicine
基金
江西省中医药管理局科技计划课题(2022B520)。
关键词
血清肌酐监测
复方苦参注射液
肺癌化疗
肾毒性
Serum creatinine monitoring
Compound Kushen Injection
Lung cancer chemotherapy
Nephrotoxicity
