摘要
探讨顺铂(DDP)化疗肾毒性的早期诊断方法。方法 :动态检测48例患者接受大剂量DDP(100～120mg/m2)化疗87个周期的血清尿素氮(BUN)、肌酐(Cr),以及尿 β2 -微球蛋白(β2 -MG)、α1 -微球蛋白(α1 -MG)、白蛋白(Alb)、转铁蛋白(TRF)、维生素A1结合蛋白(RBP)、N 乙酰 β 氨基葡萄糖苷酶(NGA)和总氨基酸(TAA)等项目 ,筛选出有价值的早期诊断顺铂肾毒性的指标。结果 :(1)化疗早期(d1～5),患者尿β2 -MG和α1 -MG出现异常增高的周期数明显多于其它指标(P<0 001) ;(2)血清BUN和Cr异常增高的周期数在化疗后期(d10或d15)明显增多 ;(3)血清BUN和Cr异常的患者 ,化疗早期均有尿 β2 -MG和/或α1 -MG异常增高(P<0 05)。结论 :(1)测定尿β2 -MG和/或α1 -MG对顺铂化疗肾毒性的早期诊断具有重要的临床应用价值 ;(2)化疗早期 ,尿β2 -MG>(467 5±74)μg/L或α1 -MG>(25 4±4 2)mg/L者提示可能发生不可逆的肾功能损害 。
Objective: To study the early diagnosis method of nephrotoxicity induced by cisplatin Methods: The serum BUN,Cr and urine β2-microglobulin(β2-MG),α1-microglobulin(α1-MG),albumin (Alb),transferrin (TRF), retinol binding protein (RBP), n acetyl β amino glucosidic enzyme (NAG), total amino acid (TAA) were measured dynamically in 48 patientsreceived high dose DDP(100～120 mg/m2) chemotherapy during 87 cycles, and some valuabe indexes of early diagnosis of nephrotoxicity were screened Results: ①In the patients of early stage of chemotherapy (d1～5), the number of withcycles abnormal elevation of urine β2-MG and α1-MG were much more than those of other indexes (P<0 001) ②The cycles of abnormal serum BUN and Cr were increased significantly in the patients of late period of chemotherapy (d10 or d15) ③There were abnormal elevation of urine β2-MG and α1-MG in the all patients whose levels were serum BUN and Cr at the early stage of chemotherapy (P<0 05) Conclusion: ①The measurement of urine β2-MG and /orα1-MG has an important clinical value for early diagnosis of nephrotoxicity ②There may be an irreversible renal function damage when patient's urine β2-MG is more than (467 5±74 3) μg/L and/or urine α1-MG more than (25 4±42) mg/L, and the dosage of DDP must be decreased or withdrawn at the moment
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2000年第8期789-791,共3页
Chinese Journal of Cancer
