中国医药导报
中國醫藥導報
중국의약도보
China Medical Herald
2015年
29期
108-111
,共4页
张红欣%韩鲁军%安召伟%许会军%胡智慧%李颖
張紅訢%韓魯軍%安召偉%許會軍%鬍智慧%李穎
장홍흔%한로군%안소위%허회군%호지혜%리영
还原型谷胱甘肽%表阿霉素%心脏毒性
還原型穀胱甘肽%錶阿黴素%心髒毒性
환원형곡광감태%표아매소%심장독성
Reduced glutathione%Epirubicin%Car-diotoxicity
目的：探究还原型谷胱甘肽(GSH)对表阿霉素(EPI)所致的心脏毒性的临床保护作用。方法选取石家庄市第一医院2013年1~12月收治的乳腺癌患者60例,均为女性,采用随机数字表法将其分为两组。EPI组30例,采用环磷酰胺+EPI的化疗方案,其中环磷酰胺0.8 g,第1天静脉推注；EPI 90 mg/m2,分别于第1、8天等分静脉滴注。 GSH+EPI组30例,在上述化疗方案的基础上给予GSH 1500 mg/m2+5%葡萄糖250 mL,静脉滴注15 min,从化疗第1天起,1次/d,连用8 d。21 d为1个化疗周期,连续化疗6个周期。治疗结束后,对两组患者进行心电图、超声心动图、心肌肌钙蛋白T(cTnT)、心肌酶谱水平的检测。结果①EPI组心电图异常率明显高于GSH+EPI组,差异有统计学意义(P<0.05)。②与EPI组比较,GSH+EPI组左心室射血分数(LVEF)较高,cTnT水平较低,差异有统计学意义(P<0.05)。③两组患者化疗后肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)水平均较化疗前显著下降(P<0.05)；与GSH+EPI组比较,EPI组CK、CK-MB、LDH水平降低更明显,差异有统计学意义(P<0.05)。结论 GSH能够改善化疗患者的心电图异常率、LVEF及cTnT水平,减缓其心肌酶谱水平的下降。
目的：探究還原型穀胱甘肽(GSH)對錶阿黴素(EPI)所緻的心髒毒性的臨床保護作用。方法選取石傢莊市第一醫院2013年1~12月收治的乳腺癌患者60例,均為女性,採用隨機數字錶法將其分為兩組。EPI組30例,採用環燐酰胺+EPI的化療方案,其中環燐酰胺0.8 g,第1天靜脈推註；EPI 90 mg/m2,分彆于第1、8天等分靜脈滴註。 GSH+EPI組30例,在上述化療方案的基礎上給予GSH 1500 mg/m2+5%葡萄糖250 mL,靜脈滴註15 min,從化療第1天起,1次/d,連用8 d。21 d為1箇化療週期,連續化療6箇週期。治療結束後,對兩組患者進行心電圖、超聲心動圖、心肌肌鈣蛋白T(cTnT)、心肌酶譜水平的檢測。結果①EPI組心電圖異常率明顯高于GSH+EPI組,差異有統計學意義(P<0.05)。②與EPI組比較,GSH+EPI組左心室射血分數(LVEF)較高,cTnT水平較低,差異有統計學意義(P<0.05)。③兩組患者化療後肌痠激酶(CK)、肌痠激酶同工酶(CK-MB)、乳痠脫氫酶(LDH)水平均較化療前顯著下降(P<0.05)；與GSH+EPI組比較,EPI組CK、CK-MB、LDH水平降低更明顯,差異有統計學意義(P<0.05)。結論 GSH能夠改善化療患者的心電圖異常率、LVEF及cTnT水平,減緩其心肌酶譜水平的下降。
목적：탐구환원형곡광감태(GSH)대표아매소(EPI)소치적심장독성적림상보호작용。방법선취석가장시제일의원2013년1~12월수치적유선암환자60례,균위녀성,채용수궤수자표법장기분위량조。EPI조30례,채용배린선알+EPI적화료방안,기중배린선알0.8 g,제1천정맥추주；EPI 90 mg/m2,분별우제1、8천등분정맥적주。 GSH+EPI조30례,재상술화료방안적기출상급여GSH 1500 mg/m2+5%포도당250 mL,정맥적주15 min,종화료제1천기,1차/d,련용8 d。21 d위1개화료주기,련속화료6개주기。치료결속후,대량조환자진행심전도、초성심동도、심기기개단백T(cTnT)、심기매보수평적검측。결과①EPI조심전도이상솔명현고우GSH+EPI조,차이유통계학의의(P<0.05)。②여EPI조비교,GSH+EPI조좌심실사혈분수(LVEF)교고,cTnT수평교저,차이유통계학의의(P<0.05)。③량조환자화료후기산격매(CK)、기산격매동공매(CK-MB)、유산탈경매(LDH)수평균교화료전현저하강(P<0.05)；여GSH+EPI조비교,EPI조CK、CK-MB、LDH수평강저경명현,차이유통계학의의(P<0.05)。결론 GSH능구개선화료환자적심전도이상솔、LVEF급cTnT수평,감완기심기매보수평적하강。
Objective To explore the protective effect of reduced glutathione (GSH) for cardiotoxicity caused by Epiru-bicin (EPI). Methods Sixty cases of female patients with breast cancer admitted to the First Hospital of Shijiazhuang City from January to December 2013 were selected and divided into two groups according to random number table. Thirty cases of EPI group were taken chemotherapy regimen of Cyclophosphamide combined with EPI, of which, Cy-clophosphamide 0.8 g, intravenous injection in the first day; intravenous drip of EPI 90 mg/m2 for equal division of ad-ministration in the first, eighth day respectively. Thirty cases of GSH+EPI group were given GSH 1500 mg/m2+5% glu-cose 250 mL on basis of chemotherapy regimen above, intravenous drip for 15 min, from the first day of chemotherapy, once a day, continued for 8 d. 21 days were as one course, for 6 courses continuously. After treatment, the ECG, ultra-sonic cardiogram, cardiac troponin T (cTnT), myocardial enzymes of the two groups were detected. Results ①The ab-normality rate of ECG in EPI group was higher than that of GSH+EPI group, the difference was statistically significant (P<0.05).②Compared with EPI group, the left ventricular ejection fraction (LVEF) of GSH+EPI group was higher, the level of cTnT was lower, the differences were statistically significant (P<0.05).③The levels of creatine kinase (CK), crea-tine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH) after chemotherapy in the two groups were all decreased sig-nificantly compared with before chemotherapy (P<0.05);compared with GSH+EPI group, the levels of CK, CK-MB, LDH in EPI group were decreased more significantly, the differences were statistically significant (P < 0.05). Conclusion GSH can improve the abnormality rate of ECG, LVEF and levels of cTnT of patients undergoing chemotherapy, and slow down the decrease of myocardial enzymes.
