还原型谷胱甘肽改善化疗药物性肝脏损害的临床研究

A Clinical Study of Reduced Glutathione in Alleviating Liver Impairment Caused by Chemotherapical Medicines

目的:探讨还原型谷胱甘肽(GSH)注射液对化疗药物性肝脏损害的改善作用。方法:采用临床对照试验,将2129例诊断明确且排除肝脏转移性癌及原发性肝癌的恶性肿瘤患者分为3组。将1782例肝功能正常者分为GSH组和对照组,化疗同时及结束后GSH组(942例),用GSH2.4g,对照组(840例)用肌苷注射液0.4g、维生素C2g,1次/d,连用10d后复查肝功能;与使用化疗药物明显相关的肝功能异常者347例为治疗组,暂不化疗,而用GSH护肝治疗。结果:GSH组谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)化疗前后差值明显低于对照组(P<0.05);治疗组AST,ALT、谷氨酰转肽酶(GGT)较治疗前显著降低(P<0.01或P<0.05)。结论:GSH对恶性肿瘤患者化疗药物性肝脏损害有较好的防治作用,且不影响化疗效果。

Objective： To evaluate the effect of reduced glutathione（GSH） in alleviating liver impairment caused by chemotherapical medicines. Methods： A total of 2129 diagnosed cases of malignant cancer, with primary liver cancer and metastatic liver cancer excluded, were divided into 3 groups in terms of clinical comparison. 1782 patients in group 1 and 2 had normal liver function. For 942 cases of group 1, an intravenous drip of 2.4 g GSH was given during and after the chemotherapy. In 840 cases of group 2 for comparison, an intravenous drip of 2 g vitamine C was given to every patient once a day during and after the chemotherapy. Liver function was re- examined after 10 consecutive days of intravenous drip too. Group 3 involved 347 cases with abnormal liver function directly related to chemotherapical medicines. Group 3 temporarily accepted treatment of liver protection with GSH instead of chemotherapy. Results： The differences of ALT, AST, and ALP in group 1 before and after chemotherapy were evidently lower than those in group 2 （P〈0.05）. The levels of ALT, AST, and GGT in group 3 after GSH treatment were remarkably lower than those prior to treatment （P〈0.01 or P〈0.05）. Conclusion： GSH is apt to play an effective role of prevention and treatment in liver impairment caused by the chemotherapy for malignant cancer patients, and will not counteract the curative effect of chemotherapy.