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目的探讨卵巢癌患者化疗后脂肪肝的发生及其变化。方法选择2004年1月至2008年1月北京大学人民医院145例卵巢癌术后患者,分别在化疗前,化疗期和随访期定期进行肝功能生化检查及腹部超声检查,了解脂肪肝发生与体重指数(BMI)、化疗方案及疗程关系。结果145例卵巢癌化疗后出现脂肪肝31例(21.38%),其中轻-中度脂肪肝29例,重度脂肪肝2例。化疗后1、3、6和≥8疗程,其发生率分别为0、11.03%、18.62%和21.38%。15例脂肪肝患者出现肝功能异常,28例血脂异常。化疗前后BMI分别为23.81±5.32和24.80±5.25,差异有统计学意义(P<0.05)。化疗前并发轻度脂肪肝6例,2例化疗后发展为重度脂肪肝。化疗结束后6个月随访复查:化疗后出现的31例脂肪肝患者中,1例重度脂肪肝患者转化中度,14例轻-中度恢复正常,9例肝功能异常患者恢复为正常。化疗前合并脂肪肝的6例患者中,1例轻-中度脂肪肝患者转化为正常,1例重度患者转化为中度;1例III度肝功能异常患者转化为I度。结论卵巢癌患者术后化疗可引起脂肪肝和高脂血症,并可加重其病情。
Objective To investigate the occurrence and changes of fatty liver in patients with ovarian cancer after chemotherapy. Methods From January 2004 to January 2008, 145 patients with ovarian cancer who were from Peking University People’s Hospital were enrolled in this study. Liver biochemical tests and abdominal ultrasonography were performed before chemotherapy, chemotherapy and follow-up respectively to understand the relationship between fatty liver disease and body weight Index (BMI), chemotherapy regimen and course of treatment. Results There were 31 cases (21.38%) of fatty liver after chemotherapy in 145 cases of ovarian cancer, including 29 cases of mild-moderate fatty liver and 2 cases of severe fatty liver. 1,3,6 and 8 courses after chemotherapy, the incidence rates were 0,11.03%, 18.62% and 21.38%. Hepatic dysfunction occurred in 15 cases of fatty liver and 28 cases of dyslipidemia. Before and after chemotherapy BMI were 23.81 ± 5.32 and 24.80 ± 5.25, the difference was statistically significant (P <0.05). Six patients had mild fatty liver before chemotherapy, and two patients developed severe fatty liver after chemotherapy. Six months after chemotherapy, follow-up review: Of the 31 patients with fatty liver after chemotherapy, one patient with severe fatty liver had moderate conversion, 14 mild to moderate normal, and 9 patients with abnormal liver function returned to normal. One patient with mild to moderate fatty liver turned normal, one patient with moderate to severe disease turned moderate, and one patient with grade III hepatic dysfunction turned to degree I in 6 patients with preoperative chemotherapy for fatty liver. Conclusion Postoperative chemotherapy in patients with ovarian cancer can cause fatty liver and hyperlipidemia, and may aggravate their condition.