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目的探讨伊立替康联合顺铂化疗致严重不良反应的发生机制。方法回顾分析1例小细胞肺癌予伊立替康联合顺铂化疗致严重不良反应的临床资料。结果本例因间断性干咳就诊,在外院诊断为小细胞肺癌予依托泊苷+顺铂化疗5个周期,效果不明显。入我院后行伊立替康+顺铂常规剂量化疗,化疗12 d后出现重度腹泻,经相应检查诊断为重度迟发型腹泻、骨髓抑制、肝肾功能损害。予相应治疗后出院。结论伊立替康所致严重不良反应存在个体差异,与尿苷二磷酸葡萄糖醛酸转移酶家族的表达及活性密切相关。有望通过基因组学技术来预测伊立替康的毒性,指导临床剂量的选择,以达到个体化治疗的目标。
Objective To investigate the mechanism of serious adverse reactions induced by irinotecan combined with cisplatin. Methods A retrospective analysis of 1 case of small cell lung cancer to irinotecan combined with cisplatin chemotherapy caused serious adverse clinical data. Results of this case of intermittent dry cough treatment, diagnosis of small cell lung cancer in small cell lung cancer to etoposide + cisplatin chemotherapy 5 cycles, the effect is not obvious. Into our hospital after irinotecan + cisplatin conventional chemotherapy, chemotherapy 12 days after severe diarrhea, the corresponding examination was diagnosed as severe delayed diarrhea, bone marrow suppression, liver and kidney dysfunction. To the appropriate treatment after discharge. Conclusion There are individual differences in serious adverse reactions caused by irinotecan, which are closely related to the expression and activity of uridine diphosphate glucuronosyltransferase family. It is expected to predict the toxicity of irinotecan through genomics technology and to guide the choice of clinical dosage in order to achieve the goal of individualized treatment.