Droller M J, Saral R, Santos G
Urology. 1982 Sep;20(3):256-8. doi: 10.1016/0090-4295(82)90633-1.
The occurrence of hemorrhagic cystitis with the use of high-dose cyclophosphamide is thought to be a toxic effect of cyclophosphamide metabolites directly on the bladder mucosa. To decrease both the concentration of metabolites in contact with the bladder mucosa and the time of such contact, a regimen of diuresis and frequent voiding or catheter drainage was instituted in patients at risk for the development of hemorrhage. Prior to institution of this regimen, 8 of 97 patients experienced massive clot-producing hemorrhage, three-quarters of whom died as a direct result of such hemorrhage. Subsequent to use of this regimen, only 1 of 198 patients experienced this degree of hemorrhage. Although this is only a phase II study, the dramatic decrease in the incidence of hemorrhage strongly suggests the efficacy of this regimen in decreasing the potential morbidity associated with cyclophosphamide-induced hemorrhagic cystitis.
使用高剂量环磷酰胺时发生出血性膀胱炎被认为是环磷酰胺代谢产物直接对膀胱黏膜产生的毒性作用。为了降低与膀胱黏膜接触的代谢产物浓度以及这种接触的时间，对有出血风险的患者制定了利尿、频繁排尿或导尿引流方案。在实施该方案之前，97例患者中有8例发生大量产生血凝块的出血，其中四分之三直接死于这种出血。使用该方案后，198例患者中只有1例发生了这种程度的出血。尽管这只是一项II期研究，但出血发生率的显著降低强烈表明该方案在降低与环磷酰胺诱导的出血性膀胱炎相关的潜在发病率方面的有效性。
