目的 探究保肝药在急性髓系白血病(AML)患者化疗中预防肝损伤发生的临床意义。方法 回顾性分析某三甲医院血液科2012年1月至2015年12月接受IA方案治疗的128例初诊AML患者使用肝病辅助治疗药(保肝药)预防肝损伤发生的情况。128例病例中使用保肝药物预防的试验组99例，未使用保肝药物预防的对照组29例，试验组又包含谷胱甘肽预防组、异甘草酸镁预防组、谷胱甘肽合并异甘草酸镁预防组以及其他组。试验组在初次诱导化疗的同时使用保肝药物;对照组仅接受化疗，并记录两组患者化疗前后的肝功能生化指标。结果 试验组肝损伤发生率和对照组相比无显著性差异(P>0.05)，三组保肝药之间的预防效果无显著性差异(P>0.05)，经Cox回归对肝损伤发生的相关因素分析，无显著性差异(P>0.05)。结论 预防性使用保肝药物并未减少接受IA方案化疗的初治AML患者的肝损伤的发生。
Abstract
OBJECTIVE To investigate the preventive effect of hepatoprotective agents against liver injury induced by initial chemotherapy in patients with acute myeloid leukemia (AML). METHODS A total of 128 patients with newly diagnosed AML in the department of hematology of one tertiary hospital who received IA regimen were enrolled into this study during the period of January 2012 to December 2015. Using a retrospective study design, differences were assessed between the group treated with hepatoprotective agents (experimental group; n=99) and that withou hepatoprotective agents (control group; n=29). The experimental group was further divided into four groups, ie, glutathione group, magnesium isoglycyrrhizinate group, glutathione combined with magnesium isoglycyrrhizinate group, and the other group. The patients in the experimental group were treated with hepatoprotective agents at the first time of inducing chemotherapy while the patients in the control group received inducing chemotherapy only. The biochemical indexes for liver function of all the patients were recorded. RESULTS There was no significant difference in the incidence of liver injury between the experimental group and control group (P>0.05),and the preventive effects in the three groups were similar (P>0.05). Cox regression analysis of the related factors of the occurrence of liver injury showed that there was no significant difference (P>0.05). CONCLUSION Prophylactic use of hepatoprotective agents does not reduce the incidence of liver injury among treatment-naive patients with AML who have received IA regimen.
关键词
保肝药 /
急性髓系白血病 /
化疗 /
肝损伤 /
预防作用
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Key words
hepatoprotective agent /
acute myeloid leukemia /
chemotherapy /
liver injury /
preventive effect
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中图分类号：
R969.4
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参考文献
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