CAJ | 학술논문

目的：探讨酚麻美敏片对于肾癌术后患者应用干扰素治疗后出现的流感样症状有无预防作用。方法2010年10月~2013年4月共有76例肾癌患者于北京积水潭医院行肾癌根治术，所有患者均于术后1周开始每周3次皮下注射干扰素α治疗。剂量为第1周每次3 MU，第2周每次6 MU，如患者可以耐受，则维持每次6 MU注射至术后12周。如患者无法耐受，则降至3 MU甚至停药。患者被随机分为两组，每组各38例，实验组在每次注射干扰素α后半小时开始每6小时服用酚麻美敏片1片，24 h后停药。对照组单独使用干扰素α治疗。比较两组患者在首剂及加量使用干扰素后24 h内的发热及其他流感样症状情况。结果首剂使用干扰素后，实验组患者发热比率为13.2%，而对照组为81.6%，差异有高度统计学意义(P<0.01)。实验组患者发生寒战、头痛、乏力的比率和对照组相比明显降低(P<0.05)，而全身酸痛症状两组差异无统计学意义(P>0.05)。对照组中有4例患者无法耐受干扰素带来的严重不适，拒绝加量治疗。而实验组所有患者均参与加量治疗。干扰素加量治疗后实验组发热比率为21.1%，而对照组为85.3%(P<0.01)。而其他流感样症状两组比较差异均有统计学意义(均P<0.05)。治疗后对照组又有4例患者因超高热而不得不降为每次3 MU治疗。相比之下，实验组无患者出现无法耐受而减量的情况。结论酚麻美敏片对于预防干扰素α治疗肾癌术后患者所致流感样症状有明显的效果，并且可以显著提高患者的治疗顺应性。
목적：탐토분마미민편대우신암술후환자응용간우소치료후출현적류감양증상유무예방작용。방법2010년10월~2013년4월공유76례신암환자우북경적수담의원행신암근치술，소유환자균우술후1주개시매주3차피하주사간우소α치료。제량위제1주매차3 MU，제2주매차6 MU，여환자가이내수，칙유지매차6 MU주사지술후12주。여환자무법내수，칙강지3 MU심지정약。환자피수궤분위량조，매조각38례，실험조재매차주사간우소α후반소시개시매6소시복용분마미민편1편，24 h후정약。대조조단독사용간우소α치료。비교량조환자재수제급가량사용간우소후24 h내적발열급기타류감양증상정황。결과수제사용간우소후，실험조환자발열비솔위13.2%，이대조조위81.6%，차이유고도통계학의의(P<0.01)。실험조환자발생한전、두통、핍력적비솔화대조조상비명현강저(P<0.05)，이전신산통증상량조차이무통계학의의(P>0.05)。대조조중유4례환자무법내수간우소대래적엄중불괄，거절가량치료。이실험조소유환자균삼여가량치료。간우소가량치료후실험조발열비솔위21.1%，이대조조위85.3%(P<0.01)。이기타류감양증상량조비교차이균유통계학의의(균P<0.05)。치료후대조조우유4례환자인초고열이불득불강위매차3 MU치료。상비지하，실험조무환자출현무법내수이감량적정황。결론분마미민편대우예방간우소α치료신암술후환자소치류감양증상유명현적효과，병차가이현저제고환자적치료순응성。
Objective To explore whether Paracetamol can prevent cold-like symptoms caused by α-interferon in the treatment of renal carcinoma after radical nephrectomy. Methods From October 2010 to April 2013, 76 renal carcino-ma patients who underwent nephrectomy in Beijing Jishuitan Hospital were treated by α-interferon 3 times per week from the first week after operation. 3 million units each time for the first week, and 6 million units for the second week were given to every patient, if the patient could tolerate, the dose would be maintained until the 12th week after opera-tion, otherwise, the dose would be reduced to 3 million units or even withdraw. All the patients were randomized into 2 groups. There were 38 cases in each group. In the treatment group, the patients were treated by α-interferon injection plus Paracetamol 1 pill every 6 hours until 24 hours later, and α-interferon injection alone in the control group. Re-sults After the first time of α-interferon injection, patients with fever were 13.2% in the treatment group and 81.6% in the control group the difference was statistically significant (P<0.01). Patients with chill, headache and fatigue in the treatment group were significantly less than the control group (P<0.05), and there was no statistical difference for the myalgia symptom between two groups (P > 0.05). There were four patients refused to increase the dose because of severe symptoms, but no patients stopped interferon therapy in the treatment group. After increasing the dose of interfer-on, 21.1%of patients in the treatment group had fever, and 85.3%in the control group (P<0.01). There were statisti-cal differences between the 2 groups for the other cold-like symptoms (all P < 0.05). All patients in the treatment group could stand the interferon therapy, but in the control group, there were 4 patients had to reduce the dose to 3 MU each time because of ultrahyperpyrexia. Conclusion Paracetamol may have significant effect on preventing cold-like symptoms caused byα-interferon in the treatment of renal carcinoma after radical nephrectomy, and it can enhance the tolerance of patients.