毒理性
血清转氨酶升高发生在多达三分之二的使用链脲佐菌素治疗的病人中,但异常通常是轻微的、暂时的,并且不伴随症状或黄疸。每日剂量和高剂量的链脲佐菌素更常见肝毒性,但高剂量时,肾脏和血液毒性通常超过肝脏损伤。已有两例报告在使用链脲佐菌素治疗的病人中出现了快速进展且致命的急性肝衰竭。在一个案例中,没有给予其他化疗,在另一个案例中,氟尿嘧啶同时给药,病人在5天治疗结束时时出现了发热、无尿、急性肝炎[ALT 1280,胆红素 11.9,凝血酶原指数 10%,嗜酸性粒细胞 2600/μL]。相比之下,尚未有单独发表的个案报告将链脲佐菌素归因于自限性临床明显的肝损伤,但由于胰腺胰岛细胞癌和神经内分泌肿瘤较为罕见,链脲佐菌素的使用受到了限制。
Serum aminotransferase elevations occur in up to two-thirds of patients treated with streptozocin, but the abnormalities are generally mild, transient and not associated with symptoms or jaundice. Hepatotoxicity is more common with daily dosing and high doses of streptozocin, but with higher doses renal and hematologic toxicities usually overshadow hepatic injury. There have been two reports of rapidly progressive and fatal acute liver failure in patients treated with streptozocin. In one instance, no other chemotherapy was given, in another fluorouracil was coadministered and the patient presented with fever, anuria, acute hepatitis [ALT 1280, bilirubin 11.9, prothrombin index 10%, eosinophils 2600/ µL] at the end of a 5 day course of treatment. In contrast, there have been no individual published case reports of self-limited clinically apparent liver injury attributed to streptozocin, but it has had limited use, as pancreatic islet cell carcinoma and neuroendocrine tumors are rare.
来源:LiverTox