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1例表皮生长因子受体阳性的初诊78岁男性肺癌患者接受厄洛替尼150 mg,1次/d口服化疗。化疗前丙氨酸转氨酶(ALT)12 U/L,天冬氨酸转氨酶(AST)16 U/L,总胆红素(TBil)22.0μmol/L,直接胆红素(DBil)7.6μmol/L。化疗2周复查:ALT 30 U/L,AST 33 U/L,TBil 20.0μmol/L,DBil 6.3μmol/L。化疗2个月患者出现尿色加深,全身皮肤及巩膜黄染。化疗约75 d实验室检查:ALT 368 U/L,TBil 182.1μmol/L,DBil 155.2μmol/L。停用厄洛替尼,予保肝治疗。停药第4天,ALT 171 U/L,AST 177 U/L,TBil 322.0μmol/L,DBil 278.2μmol/L。停药第6天,加用甲泼尼龙。停药第12天,ALT 132 U/L,AST 141 U/L,TBil 172.6μmol/L,DBil 135.4μmol/L。停用厄洛替尼2个月,ALT 12 U/L,AST 30U/L,TBil 19.8μmol/L,DBil 13.5μmol/L。随后换用吉西他滨联合尼妥珠单抗继续化疗6个疗程,未再出现肝功能异常。
One case of epidermal growth factor receptor-positive newly diagnosed 78-year-old male patient with lung cancer received oral chemotherapy with erlotinib 150 mg once daily. Before chemotherapy, 12 U / L of ALT, 16 U / L of aspartate aminotransferase (AST), 22.0 μmol / L of total bilirubin (TBil), 7.6 μmol / L of direct bilirubin . Two weeks after chemotherapy: ALT 30 U / L, AST 33 U / L, TBil 20.0 μmol / L, DBil 6.3 μmol / L. 2 months of chemotherapy patients with dark urine, systemic skin and sclera yellow dye. Chemotherapy for about 75 days Laboratory tests: ALT 368 U / L, TBil 182.1 μmol / L, DBil 155.2 μmol / L. Erlotinib disabled, to liver protection treatment. On the fourth day, ALT 171 U / L, AST 177 U / L, TBil 322.0 μmol / L and DBil 278.2 μmol / L. On the sixth day, add methylprednisolone. On the 12th day of withdrawal, ALT 132 U / L, AST 141 U / L, TBil 172.6 μmol / L, DBil 135.4 μmol / L. Erlotinib was discontinued for 2 months, ALT 12 U / L, AST 30 U / L, TBil 19.8 μmol / L, DBil 13.5 μmol / L. Followed by gemcitabine combined with nimotuzumab continue chemotherapy for 6 courses, no recurrence of liver dysfunction.