中文摘要：

目的：研究胃肠道恶性肿瘤患者术后辅助化疗中肝损伤的发生率,并对其相关因素进行分析。方法：回顾分析南京大学医学院附属鼓楼医院肿瘤中心自2010年至2015年收治的200例胃肠道恶性肿瘤术后辅助化疗患者,统计其化疗肝损伤发生率,利用χ2检验等统计方法,研究相关因素对化疗肝损伤发生率的影响。结果：200例胃肠道恶性肿瘤患者化疗中肝损伤的发生率为58.0%,其中I度肝损伤39.0%,II度肝损伤16.5%,III度肝损伤2.5%。化疗肝损伤的发生与患者年龄、性别、肿瘤类型、分期等因素无显著相关性（P〉0.05）;既往有长期酗酒史及乙肝病毒携带者可增加化疗肝损伤的发生率（P〈0.05）,且更易在化疗早期发生肝损伤;疗程中出现II度以上消化道反应者可增加化疗肝损伤的发生率（P〈0.05）;胃癌患者采用三药联合方案化疗的肝损伤发生率比两药联合方案高（P〈0.05）。结论：胃肠道恶性肿瘤患者术后辅助化疗肝损伤发生率较高,但多为轻度肝损。有长期酗酒史、乙肝病毒携带者及疗程中发生严重消化道反应等是发生化疗肝损伤的高危因素。对于这些患者应避免使用三药联合方案化疗,可以预防性应用保肝药物以降低化疗肝损伤的发生,保障患者按时、足量完成预定的化疗周期。

英文摘要：

Objective： To investigate the incidence and risk factors of chemotherapy induced liver injury of gastro- intestinal cancer patients in adjuvant chemotherapy following radical surgery. Methods： Collected the data of two hun- dred cases of gastrointestinal cancer patients in adjuvant chemotherapy following radical surgery were studied who re- ceived treatment in the oncology department of Nanjing Drum Tower Hospital from 2010 to 2015. Square test was used to investigate the correlation between the incidence and the risk factors of liver injury. Results：The incidence of liver injury of gastrointestinal cancer patients in adjuvant chemotherapy was 58.0% ,including 39.0% in grade I, 16.5% in grade II and 2.5% in grade III. History of chronic virus hepatitis B and long term alcohol abuse could increase the incidence of liver injury （P 〈 0.05） and liver injury would develope more earlier in those patients. Liver injury was more common in the patients with severe gastrointestinal reactions （P 〈 0.05 ）. The incidence of liver injury of three drugs chemotherapy was higher than those of two drugs chemotherapy （P 〈0.05 ）. The incidence of liver injury was not significantly correlated with age, gender, types of tumor, or the stage （P 〉 0. 05）. Conclusion： The incidence of liver injury of gastrointestinal cancer patients in adjuvant chemotherapy following radical surgery is high, but many are minor. The risk factors of chemotherapy induced liver injury include history of chronic virus hepatitis B,long term al- cohol abuse and severe gastrointestinal reactions. We should avoid using three drugs chemotherapy in these patients. Prophylactic use of some drug to protect liver could decrease the incidence of liver injury and protect on time and suf- ficient chemotherapy.