【作者】 王临润； 张国兵； 黄明珠；

【Author】 WANG Lin Run ZHANG Guo Bing HUANG Ming Zhu The First Affiliated Hospital,College of Medicine(Hangzhou 310003,China)

【机构】 浙江大学医学院附属第一医院；

【摘要】 目的:研究吉西他滨2小时固定速率输注在非小细胞肺癌患者中的峰浓度(C_max)与血液学毒性的相关性.方法:选择21例患者,吉西他滨(1200mg·m^-2)2小时固定速率静脉输注联合卡铂的给药方案.采用离子对反相高效液相色谱法测定吉西他滨血药浓度.结果:吉西他滨平均 C_max为（4.95±2.42）μg·mL^-1.血液学毒性主要为Ⅲ～Ⅳ级的血小板和中性粒细胞减少症.白细胞计数平均下降百分率为（38.3±38.1）%,中性粒细胞计数下降（31.3±73.6）%,血小板计数下降 （31.8±53.5）%,血红蛋白计数下降（12.0±12.2）%.C_max与白细胞计数下降百分率存在相关性 （r²=0.4575,P<0.05）,同样 C_max与血小板计数下降百分率存在相关性（r²=0.5671,P<0.05）.结论:作为治疗 NSCLC 一线的有效化疗方案,患者对其血液学毒性可以耐受,治疗有较好的依存性.对 C_max与血液学毒性的相关性研究,为吉西他滨个体化给药,从而减少不良反应提供了依据.更多还原

【Abstract】 Objective:To investigate the relationship between peak concentration(C_max)of fixed- dose-rate gemcitabine and hematological toxicity profile in patients with advanced non-small-cell lung cancer（NSCLC）.Methods:The study was performed on 21 patients,who were administered gemcitabine at a fixed dose rate(1200mg·m^-2,over 120 min)with carboplatin.Plasma concentrations of gemcitabine were measured by ion-pair reversed-phase high-performance liquid chromatography.Results:The mean value of C_maxof 21 eligible patients was（4.95±2.42）μg·mL^-1.The main hematological toxicities were grade Ⅲ～Ⅳ thrombocytopenia and neutropenia.The mean percentages of reduction of WBC,NEC, PLTC and lib of 21 eligible patients were（38.3±38.1）%,4,（31.3±73.6）%,（31.8±53.5）% and（12.0± 12.2）%,respectively.The C_maxof gemcitabine and the percentage of reduction in WBC showed a significant correlation（r²=0.4575,p<0.05）.A significant correlation（r²=0.5671,p<0.05）was also observed between the percentage of reduction of PLTC and C_maxof gemcitabine.Conclusion:With the results of hematological toxicities,the regimen has shown good profile of tolerability in Chinese patients. Furthermore,the relationship between C_maxand toxicity profile supports gemcitabine administration with individuation in order to decrease the occurrence of ADR.更多还原