Early changes in ammonia levels and liver function in patients with advanced hepatocellular carcinoma treated by lenvatinib therapy
Early changes in ammonia levels and liver function in patients with advanced hepatocellular carcinoma treated by lenvatinib therapy
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DOI：
10.1038/s41598-019-48045-z
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发表时间：
2019-08-20
影响因子：
4.6
通讯作者：
Aikata, Hiroshi
中科院分区：
文献类型：
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作者：
Ohya, Kazuki;Kawaoka, Tomokazu;Aikata, Hiroshi
我们的目的是调查接受仑伐替尼治疗的晚期肝细胞癌患者氨水平和肝功能的早期变化。这项回顾性研究纳入了 23 名能够连续接受乐伐替尼至少 1 周的晚期肝细胞癌患者。我们比较了乐伐替尼给药前后 1 周的氨水平 (NH3)、总胆红素 (Bil)、白蛋白和凝血酶原 (PT) 活性，此外还比较了根据门体循环 (PSC) 存在/不存在划分的 2 组。在给予乐伐替尼之前，具有PSC的患者的氨水平和肝功能显着差于没有PSC的患者（分别为NH3：P = 0.013，Bil：P = 0.004，PT：P = 0.047）。此外，乐伐替尼治疗 1 周后所有患者的各项指标均较给药前恶化（分别为 NH3：P = 0.001，Bil：P = 0.025，PT：P < 0.001）。此外，对氨水平的变化进行了为期 4 周的研究。氨水平增加，在 2 周时达到峰值，但在 3 周后下降。没有患者因不良事件而停止乐伐替尼治疗。服用乐伐替尼后 1 周，研究患者的氨水平较基线升高，但通过适当的管理可以继续治疗 4 周。
We aimed to investigate the early changes in ammonia levels and liver function in patients with advanced hepatocellular carcinoma treated with lenvatinib. This retrospective study included 23 patients with advanced hepatocellular carcinoma who were able to receive lenvatinib continuously for at least 1 week. We compared their ammonia levels (NH3), total bilirubin (Bil), albumin, and prothrombin (PT) activity at before and after 1 week of lenvatinib administration, and additionally, compared the 2 groups which were divided based on the presence/absence of portosystemic collaterals (PSCs). Before administration of lenvatinib the patients with PSCs had significantly worse ammonia levels and liver function than the patients without PSCs (NH3: P = 0.013, Bil: P = 0.004, PT: P = 0.047, respectively). Moreover, the indices were worse in all the patients after 1 week of lenvatinib than before administration (NH3: P = 0.001, Bil: P = 0.025, PT: P < 0.001, respectively). Moreover, the changes in ammonia levels were investigated for 4 weeks. The ammonia level increased, to peak at 2 weeks, but decreased after 3 weeks. None of the patients discontinued lenvatinib therapy because of an adverse event. The ammonia levels of the study patients increased from baseline at 1 week after lenvatinib administration, but therapy could be continued for 4 weeks by appropriate management.