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目的 观察阿米福汀 (amifostin)保护肾脏免受顺铂 (DDP)损害的疗效及药物不良反应和安全性。方法 193例恶性肿瘤患者随机分为化疗加阿米福汀组 (观察组 )和单纯化疗组 (对照组 ) ,观察组 10 2例 ,对照组 91例。观察组和对照组患者于疗前和疗后不同时期分别测定其血象、血钙、肝功能、血尿素氮 (BUN)、肌酐 (Cr)、尿N 乙酰 β D 氨基葡萄糖苷酶与肌酐比值 (NAG/C)和尿微量白蛋白与肌酐的比值 (MAB/C)。结果 观察组 2个疗程的第 2天 ,其MAB/C与疗前的差值低于对照组第2天的MAB/C与疗前的差值 ,经统计学检验 ,P <0 .0 5。观察组 2个疗程的第 4,6 ,10 ,14天的MAB/C与疗前的差值明显低于对照组的对应点与疗前的差值 ,经统计学检验 ,P <0 .0 1。观察组第 1个疗程第 4,6 ,10天及第 2个疗程的第 2 ,4,6 ,10 ,14天的NAG/C与疗前的差值明显低于对照组的对应各点与疗前的差值 ,经统计学检验 ,P <0 .0 1;观察组第 1个疗程第 2天和第 14天的NAG/C与疗前的差值亦低于对照组 ,经统计学检验 ,P <0 .0 5。结论 阿米福汀可以明显降低观察组的MAC/C及NAG/C的量 ,表明阿米福汀对患者的肾脏功能有明显的保护作用 ,不受肿瘤类型的限制。对肺癌和卵巢癌的化疗疗效统计 ,与对照组比较 ,阿米福汀对观察组肿瘤无保护作用 (P
Objective To observe the efficacy and safety of amifostin in protecting kidneys from damage caused by cisplatin (DDP). Methods A total of 193 patients with malignant tumor were randomly divided into chemotherapy plus amifostine group (observation group) and chemotherapy alone group (control group), 102 cases in the observation group and 91 cases in the control group. The blood and serum calcium, liver function, blood urea nitrogen (BUN), creatinine (Cr), urinary N-acetyl-D-glucosaminidase and creatinine ratio in the observation group and the control group were measured before and after the treatment NAG / C) and urine microalbumin to creatinine ratio (MAB / C). Results The difference between MAB / C and pre-treatment on the second day of two courses in observation group was lower than the difference between MAB / C and pre-treatment on the second day of the control group. After statistical test, P <0.05 . The difference between MAB / C and pre-treatment on the 4th, 6th, 10th and 14th days of the observation group was significantly lower than that of the control group after 2 courses of treatment. After statistical test, P <0 .0 1. The difference between NAG / C and pre-treatment on the 2nd, 4th, 6th, 10th and 14th days in the observation group at the 4th, 6th and 10th days of the first course of treatment and the second course of treatment was significantly lower than that of the control group Differences between pre-treatment, the statistical test, P <0. 01; observation group on the first two days and 14 days of NAG / C and pre-treatment difference is also lower than the control group, statistically Test, P <0. Conclusions Amifostine can significantly reduce the amount of MAC / C and NAG / C in the observation group, indicating that amifostine has a significant protective effect on renal function in patients, regardless of tumor type. Chemotherapy for lung cancer and ovarian cancer statistics, compared with the control group, no effect of amifostine on the observation group tumors (P