异甘草酸镁防治接受化疗的晚期胃癌患者肝肾功能损伤临床研究*

doi:10.3969/j.issn.1672-5069.2023.02.021

摘要/Abstract

摘要： 目的观察应用异甘草酸镁防治接受化疗的晚期胃癌患者肝肾功能损伤的保护作用。方法 2020年4月～2022年4月我院收治的晚期胃癌患者105例,均接受多西他赛、顺铂和5-氟尿嘧啶4周4疗程化疗。将患者分成观察组53例和对照组52例,在接受化疗过程中,分别给予异甘草酸镁或谷胱甘肽预防肝肾功能损伤。采用电化学发光法检测血清糖类抗原199(CA199)、CA125、CA724和癌胚抗原(CEA)水平,采用ELISA法检测血清白介素-6(interleukin-6,IL-6)、IL-8和肿瘤坏死因子-α(TNF-α)水平。结果在化疗治疗结束时,观察组发生DILI 2例(3.8%),显著低于对照组的8例(15.4%,P<0.05),两组病例无肾损伤发生;在化疗结束时,观察组血清ALT、AST和ALP水平分别为(44.3±10.5)U/L、(27.4±2.8)U/L和(70.6±14.5)U/L,均显著低于对照组[分别为(56.6±15.3)U/L、(49.1±2.9)U/L和(82.5±8.7)U/L,P<0.05];在治疗结束后1 m,观察组血清ALT和AST水平分别为(33.5±5.8)U/L和(23.4±2.5)U/L,均显著低于对照组[分别为(42.6±7.7)U/L和(37.7±3.2)U/L,P<0.05];治疗后,两组血清CA199、CA125、CA724和CEA水平变化无显著性统计学差异(P>0.05);治疗后,观察组血清IL-6、IL-8和TNF-α水平分别为(3.9±0.5)ng/L、(57.3±5.8)ng/L和(3.4±0.4)ng/L,均显著低于对照组[分别为(5.7±0.6)ng/L、(84.2±8.5)ng/L和(6.7±0.8)ng/L,P<0.05]。结论应用异甘草酸镁防治接受化疗的晚期胃癌患者肝肾功能损伤效果肯定,可能与其降低了机体炎性反应有关。

关键词: 药物性肝损伤, 胃癌, 异甘草酸镁, 顺铂, 5-氟尿嘧啶, 治疗

Abstract: Objective The aim of this study was to observe the clinical efficacy of magnesium isoglycyrrhizinate in preventing and treating liver and kidney injuries in patients with advanced gastric cancer (AGC) undergoing chemotherapy. Methods A total of 105 patients with AGC were encountered in our hospital between April 2020 and April 2022, and all received taxotere, cisplatin and 5-fluorouracil combination chemotherapy. During the chemotherapy, the patients were randomly assigned to control (n=52) and observation group (n=53), receiving glutathione or magnesium isoglycyrrhizinate for preventing drug-induced liver injury (DILI) and kidney injury. Serum carbohydrate antigen 199 (CA199), CA125, CA724 and carcinoembryonic antigen (CEA) levels wereassayed by electrochemical luminescence, and serum interleukin-6 (IL-6), IL-8 and tumor necrosis factor-α(TNF-α) levels were detected by ELISA. Results At the end of chemotherapy, the incidence of DILI in the observation group was 3.8%, much lower than 15.4% (P<0.05) in the control, and no kidney injury occurred in the two groups; serum ALT, AST and ALP levels in the observation group were (44.3±10.5)U/L, (27.4±2.8)U/L and (70.6±14.5)U/L, all significantly lower than [(56.6±15.3)U/L,(49.1±2.9)U/L and (82.5±8.7)U/L, respectively, P<0.05] in the control; at the end of one month after chemotherapy, serum ALT and AST levels in the observation group were (33.5±5.8)U/L and (23.4±2.5)U/L, both significantly lower than [(42.6±7.7)U/L and (37.7±3.2)U/L, respectively,P<0.05] in the control; after treatment, serum CA199, CA125, CA724 and CEA levels in the two groups were not significantly different(P>0.05), while serum IL-6, IL-8 and TNF-α levels in the observation group were (3.9±0.5)ng/L,(57.3±5.8)ng/L and (3.4±0.4)ng/L, all significantly lower than [(5.7±0.6)ng/L, (84.2±8.5)ng/L and (6.7±0.8)ng/L, respectively, P<0.05] in the control group. Conclusion The application of magnesium isoglycyrrhizinate in preventing and treating patients with AGC undergoing chemotherapy is efficacious, which might be related to the inhibition of body inflammatory reactions.

Key words: Drug-induced liver injury, Gastric cancer, Magnesium isoglycyrrhizinate, Cisplatin, 5-fluorouracil, Therapy

徐菁, 刘坤, 马竹芳. 异甘草酸镁防治接受化疗的晚期胃癌患者肝肾功能损伤临床研究^*[J]. 实用肝脏病杂志, 2023, 26(2): 234-237.

Xu Jing, Liu Kun, Ma Zhufang. Clinical efficacy of magnesium isoglycyrrhizinate in preventing and treating liver and kidney injuries in patients with advanced gastric cancer undergoing chemotherapy[J]. Journal of Practical Hepatology, 2023, 26(2): 234-237.

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异甘草酸镁防治接受化疗的晚期胃癌患者肝肾功能损伤临床研究^*

Clinical efficacy of magnesium isoglycyrrhizinate in preventing and treating liver and kidney injuries in patients with advanced gastric cancer undergoing chemotherapy

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