肾癌术后患者5-氟尿嘧啶血药浓度与肾功能及毒副作用的相关性研究

发布时间：2019-01-22 10:56

【摘要】：目的探讨肾癌术后患者5-氟尿嘧啶(5-FU)血药浓度与肾功能、毒副作用的关系,为实施个体化治疗提供依据。方法选取2013年8月—2016年2月在海南省人民医院泌尿外科行肾癌根治性切除术患者92例为研究对象,均给予基于5-FU的综合化疗,共4个疗程。检测化疗后5-FU血药浓度与肾功能指标尿素氮(BUN)、肌酐(Cr)水平,采用WHO毒性分级标准评价骨髓抑制、胃肠道反应、手足综合征、口腔黏膜炎等毒副作用的严重程度。根据5-FU血药浓度,将患者分为300.0μg/L组(42例)和≥300.0μg/L组(50例)。结果 92例患者5-FU血药浓度为179.2~1 589.6μg/L,平均(569.5±29.5)μg/L。≥300.0μg/L组血清BUN、Cr水平均高于300.0μg/L组,骨髓抑制、胃肠道反应、手足综合征、口腔黏膜炎等毒副作用严重程度均高于300.0μg/L组(P0.05)。5-FU血药浓度与BUN、Cr水平呈正相关(r=0.413,P=0.008;r=0.398,P=0.010)。结论肾癌术后患者5-FU血药浓度变异性较大,5-FU血药浓度过高可导致肾功能异常,加重毒副作用,临床可通过监测5-FU血药浓度为实施个体化治疗提供依据。
[Abstract]:Objective to investigate the relationship between serum concentration of 5-fluorouracil (5-FU) and renal function and side effects in patients with renal carcinoma after operation. Methods from August 2013 to February 2016, 92 patients with renal carcinoma underwent radical nephrectomy in the Department of Urology, Hainan Provincial people's Hospital. All patients were given comprehensive chemotherapy based on 5-FU for 4 courses. The serum concentration of 5-FU and renal function index, urea nitrogen (BUN), creatinine (Cr) were measured after chemotherapy. The severity of side effects such as bone marrow suppression, gastrointestinal reaction, hand and foot syndrome, oral mucositis were evaluated by WHO toxicity classification standard. The patients were divided into 300.0 渭 g / L group (42 cases) and 鈮，

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