【摘要】目的 通过报道临床工作中发现的氟尿嘧啶和卡培他滨导致的高甘油三酯血症的案例，体现临床药师在药物治疗过程中的药学监护的意义。方法 报告5-氟尿嘧啶和卡培他滨诱导的高甘油三酯血症的识别和治疗过程，回顾文献，分析其潜在的致病机制。结果 案例1：52岁结肠癌患者，在第5周期的FOLFIRI方案化疗后出现高甘油三酯血症，血清甘油三酯升高至29.4mmol/l(正常范围0.34-1.7mmol/l)。案例2：58岁直肠癌患者，在第2个周期的XELIRI方案化疗后，血清甘油三酯升高至8.2mmol/l。二者均给予降脂药物对症处理，未减少5-氟尿嘧啶和卡培他滨的剂量，甘油三酯指标逐渐改善，并在2周内恢复良好。5-氟尿嘧啶和卡培他滨诱导的高甘油三酯血症的Naranjo评分均为8分（很可能）。结论 医师和药师应重视化疗后出现血脂异常的可能性，特别是5-氟尿嘧啶类药物引起的高甘油三酯血症，及时发现，及时干预。

【Abstract】Objective To report the cases of hypertriglyceridemia caused by fluorouracil and capecitabine found in clinical work， and to reflect the significance of pharmaceutical monitoring of clinical pharmacists during drug treatment. Methods Report on the identification and treatment process of 5-fluorouracil and capecitabine-induced hypertriglyceridemia， review the literature， and analyze the underlying pathogenic mechanisms. Results Case 1: A 52-year-old colon cancer patient developed hypertriglyceridemia after5 cycles of FOLFIRI regimen chemotherapy， with serum triglycerides increased up to 29.4mmol/l (normal range 0.34-1.7mmol/l). Case 2: A 58-year-old rectal cancer patient had an elevated serum triglycerides to 8.2 mmol/l after the second cycle of chemotherapy with the XELIRI regimen. Both were treated symptomatic with oral lipid-lowering drugs， without reducing the dose of 5-fluorouracil and capecitabine， and the triglyceride indexes gradually improved and recovered well within 2 weeks. The Naranjo score for both 5-fluorouracil and capecitabine-induced hypertriglyceridemia was 8 (most likely). Conclusions Doctors and pharmacists should pay attention to the possibility of dyslipidemia after chemotherapy， especially the hypertriglyceridemia caused by 5-fluorouracil drugs， and timely detection and intervention.

鄂尔多斯市医学重点学科建设资助项目