Marti C, Steiner R, Viollier A F
Schweiz Med Wochenschr. 1979 Dec 8;109(47):1885-7.
Ifosfamid is an alkylating cytostatic agent which appears to differ in its clinical spectrum from the chemically similar cyclophosphamid. So far, however, its pronounced urotoxicity has limited dosage. In spite of prophylactic measures such as forced diuresis and alkalinization of the urine, the treatment has frequently has to be broken off because of macrohematuria and hemorrhagic cystitis. By repeated intravenous administration of sodium-mercapto-ethan-sulfonate (NNI: Mesnum) the urotoxic side effects of ifosfamid can largely be prevented. During 26 cycles of treatment in 18 patients, asymptomatic microhematuria was observed 6 times and macrohematuria only once in a patient with vesico-vaginal fistula. In another case where therapy had had to be discontinued because of hemorrhagic cystitis in spite of conventional prophylaxis, the treatment could be continued without change in the urine sediment under prophylaxis with Mesnum. Mesnum does not affect the antitumoral activity of ifosfamid.
异环磷酰胺是一种细胞生长抑制剂，属于烷化剂，其临床谱似乎与化学结构相似的环磷酰胺有所不同。然而，到目前为止，其明显的尿路毒性限制了用药剂量。尽管采取了诸如强制利尿和尿液碱化等预防措施，但由于肉眼血尿和出血性膀胱炎，治疗常常不得不中断。通过反复静脉注射巯基乙磺酸钠（商品名：美司钠），异环磷酰胺的尿路毒性副作用在很大程度上可以得到预防。在18例患者的26个治疗周期中，仅在1例患有膀胱阴道瘘的患者中观察到6次无症状性镜下血尿，肉眼血尿仅出现1次。在另一例尽管采取了常规预防措施但仍因出血性膀胱炎而不得不中断治疗的病例中，在美司钠预防的情况下，尿液沉渣无变化，治疗得以继续进行。美司钠不影响异环磷酰胺的抗肿瘤活性。
