【摘要】：目的探討腎癌術(shù)后患者5-氟尿嘧啶(5-FU)血藥濃度與腎功能、毒副作用的關(guān)系,為實施個體化治療提供依據(jù)。方法選取2013年8月—2016年2月在海南省人民醫(yī)院泌尿外科行腎癌根治性切除術(shù)患者92例為研究對象,均給予基于5-FU的綜合化療,共4個療程。檢測化療后5-FU血藥濃度與腎功能指標(biāo)尿素氮(BUN)、肌酐(Cr)水平,采用WHO毒性分級標(biāo)準(zhǔn)評價骨髓抑制、胃腸道反應(yīng)、手足綜合征、口腔黏膜炎等毒副作用的嚴(yán)重程度。根據(jù)5-FU血藥濃度,將患者分為300.0μg/L組(42例)和≥300.0μg/L組(50例)。結(jié)果 92例患者5-FU血藥濃度為179.2~1 589.6μg/L,平均(569.5±29.5)μg/L�！�300.0μg/L組血清BUN、Cr水平均高于300.0μg/L組,骨髓抑制、胃腸道反應(yīng)、手足綜合征、口腔黏膜炎等毒副作用嚴(yán)重程度均高于300.0μg/L組(P0.05)。5-FU血藥濃度與BUN、Cr水平呈正相關(guān)(r=0.413,P=0.008;r=0.398,P=0.010)。結(jié)論腎癌術(shù)后患者5-FU血藥濃度變異性較大,5-FU血藥濃度過高可導(dǎo)致腎功能異常,加重毒副作用,臨床可通過監(jiān)測5-FU血藥濃度為實施個體化治療提供依據(jù)。
[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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