还原型谷胱甘肽预防表柔比星心肌毒性的临床观察

The prophylactic effect of reduced glutathione on the cardiotoxicity induced by epirubicin

目的:探讨还原型谷胱甘肽防治表柔比星心肌毒性的疗效。方法:共116例乳腺癌术后患者入组并随机接受4周期TA方案化疗+还原型谷胱甘肽(治疗组)治疗或仅TA方案化疗(对照组);利用心电图和AHA心功能评价标准评价两组患者的心脏毒性。结果:116例乳腺癌患者随机分入治疗组(60例)和对照组(56例),化疗后治疗组8例患者心电图诊断异常,比率为13.3%,对照组14例,比率为25%,两组比较有显著性差异(P<0.05);治疗组化疗前后心功能无改变,对照组经化疗后有3例出现心功能Ⅱ级,差别无统计学意义(P>0.05)。结论:本研究证实还原型谷胱甘肽可防治表柔比星的心肌毒性,可提高表柔比星化疗后患者生活质量。

Objective： to explore the efficacy of reduced glutathione in the prevention of epirubicin （EPI） induced cardiotoxicity. Methods： A total of 116 postoperative patients with breast cancer were enrolled and randomly assigned to 4 cycles of chemotherapy with TA regimen plus the reduced glutathione （ CT ＋ GSH arm） or 4 cycles of chemotherapy with TA regimen alone（ CT arm）. The cardiotoxicity of patients in both CT ＋ GSH and CT arm was evaluated by ECG and the AHA cardiac function evaluation criteria. Results： Sixty patients and 56 patients were accrued in CT ＋ GSH and CT arm, respectively. 8 of 60 patients （13.3 % ） in the CT ＋ GSH arm were diagnosed with an aberrant ECG, significantly higher than that of the CT arm （ 14 of 56, 25 % ）. No cardiac function change was observed before or after chemotherapy in the CT ＋ GSH arm, 3 pts in the CT arm presented a damaged cardiac function of grade II after chemotherapy, but with no statistical difference. Conclusion： We demonstrated that the re- duced glutathione was active in preventing the EPI induced cardiotoxicity and improving the quality of life of patients who have received chemotherapy with EPI.