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我们根据血浆和尿铂药代动力学与顺铂肾毒性关系的研究，提出了改良水化方案，并对３７例接受大剂量顺铂的乳癌患者，进行了两种不同水化方案的系统比较。结果表明，改良水化方案把原来输药后的利尿剂改为输药中，并增加了顺铂前１０００ｍｌ摄水量，使顺铂输注期间的尿量由平均８３７ｍｌ／３ｈ，增至２１８５ｍｌ／３ｈ，同时尿铂峰浓度从４７．３４μｇ／ｍｌ降至１３．４９μｇ／ｍｌ；并增加了夜间１２点肌注速尿一次，确保了夜间尿量不低于１００ｍｌ／ｈ，从而使肾毒性的发生率从７／１９（３６．８％）减少到１／１８（５．６％）。本研究证实了，改良水化方案通过降低尿铂峰浓度，能够进一步降低顺铂的肾毒性，且对其疗效无明显影响。
Based on the study of the relationship between plasma and urinary platinum pharmacokinetics and cisplatin nephrotoxicity, we proposed a modified hydration protocol and systematically compared two different hydration strategies in 37 breast cancer patients receiving high-dose cisplatin. . The results showed that the modified hydration program changed the original diuretic after drug delivery to drug delivery, and increased the amount of water in the first 1000ml of cisplatin, which increased the urine volume during the cisplatin infusion from an average of 837ml/3h to 2185ml/ 3h, at the same time, the urine platinum peak concentration was reduced from 47.34μg/ml to 13.49μg/ml; and increased nighttime intramuscular injection of furosemide once at 12 o’clock to ensure that nocturnal urine output was not lower than 100ml/h, thus making nephrotoxicity The incidence decreased from 7/19 (36.8%) to 1/18 (5.6%). This study confirms that the modified hydration program can further reduce the nephrotoxicity of cisplatin by reducing the urine platinum peak concentration, and has no significant effect on its efficacy.