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目的探讨监测紫杉醇血药浓度在卵巢上皮癌化疗中的临床价值。方法 61例卵巢上皮癌患者均接受紫杉醇联合卡铂化疗方案,运用免疫比浊法检测紫杉醇血药浓度,分析患者近期疗效和不良反应发生情况。结果根据药代动力学软件得出血药浓度大于0.05μmol/L的持续时间(T),将患者分成T≤31h组(31例)和T>31h组(30例)。T≤31h组有效率和临床获益率为51.61%和64.52%,T>31h组有效率和临床获益率为53.33%和76.67%,两组比较均无统计学差异(P>0.05)。发生率较高的不良反应是白细胞减少、血小板减少、贫血、恶心呕吐、脱发和肌肉疼痛。T>31h组白细胞减少发生率为83.33%,高于T≤31h组的54.84%(P<0.05),其他不良反应发生率无统计学差异(P>0.05)。结论在卵巢上皮癌患者化疗过程中,紫杉醇血药浓度持续时间与白细胞减少有关。
Objective To investigate the clinical value of monitoring the plasma concentration of paclitaxel in the chemotherapy of epithelial ovarian cancer. Methods Totally 61 patients with epithelial ovarian cancer received paclitaxel combined with carboplatin chemotherapy. The plasma concentration of paclitaxel was detected by immunoturbidimetry and the recent curative effect and adverse reactions were analyzed. Results According to the pharmacokinetics software, the duration of plasma concentration greater than 0.05μmol / L was obtained. The patients were divided into T ≤ 31h group (31 cases) and T> 31h group (30 cases). The effective rate and clinical benefit rate of T≤31h group were 51.61% and 64.52%, respectively. The effective rate and clinical benefit rate of T> 31h group were 53.33% and 76.67% respectively. There was no significant difference between the two groups (P> 0.05). The high incidence of adverse reactions are leukopenia, thrombocytopenia, anemia, nausea, vomiting, hair loss and muscle pain. The incidence of leukopenia in T> 31h group was 83.33%, higher than that in T≤31h group (54.84%, P <0.05). There was no significant difference in other adverse reactions (P> 0.05). Conclusions The duration of plasma concentration of paclitaxel is related to leukopenia in the chemotherapy of patients with epithelial ovarian cancer.