徐啸++++++满立波（等）

[摘要] 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。

[关键词] 酚麻美敏片；干扰素α；肾癌；流感样症状

[中图分类号] R737.11 [文献标识码] A [文章编号] 1673-7210（2014）10（a）-0031-04

Clinical observation of Paracetamol preventing cold-like symptoms caused by α-interferon in the treatment of renal carcinoma after radical nephrectomy

XU Xiao MAN Libo▲ HUANG Guanglin LI Guizhong LIU Ning

Department of Urology， Beijing Jishuitan Hospital， Beijing 100096， China

[Abstract] 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 carcinoma 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 operation， 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. Results 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 interferon， 21.1% of patients in the treatment group had fever， and 85.3% in the control group （P < 0.01）. There were statistical 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 by α-interferon in the treatment of renal carcinoma after radical nephrectomy， and it can enhance the tolerance of patients.

[Key words] Paracetamol； α-interferon； Renal carcinoma； Cold-like symptoms

根治性肾切除术是肾癌治疗的最主要方法。目前研究表明，肾癌根治术后应用干扰素α可以显著降低肿瘤复发率、肿瘤转移发生率，可以明显提高患者的生存率[1]，这给肾癌患者带来了福音。而几乎所有的患者在干扰素应用早期或加量时均会出现发热、寒战、头痛、全身酸痛、乏力等流感样症状。这严重制约了干扰素的应用，有好多患者均因此不得不减量甚至停药。……