氢化泼尼松和谷胱甘肽在乳腺癌化疗临床应用的观察

Clinical observation of hydroprednisone and glutathione in chemotherapy of breast cancer

目的:探讨氢化泼尼松(PNS)和谷胱甘肽(GSH)在乳腺癌蒽环类化疗中对化疗毒副反应的作用。方法:接受蒽环类化疗的乳腺癌患者102例,随机分为治疗组52例和对照组50例。治疗组在常规止吐药(5-HT3受体拮抗剂-托烷司琼)的基础上予PNS和GSH静脉注射;对照组仅予止吐(5-HT3受体拮抗剂-托烷司琼)处置。观察两组患者消化道反应、骨髓抑制、心脏毒性及肝功能损害等情况。结果:在化疗中应用PNS和GSH,治疗组恶心呕吐和肝脏丙氨酸氨基转移酶(ALT)升高的发生率均显著低于对照组(P=0.03,P=0.001)。在白细胞减少和心电图改变方面,两组间数据比较差异无统计学意义,P>0.05。结论:PNS和GSH在乳腺癌蒽环类化疗中能有效地减轻化疗过程中恶心呕吐的程度、控制肝脏ALT的升高。

OBJECTIVE：To discuss whether hydroprednisone and glutathione can reduce the toxic and side effect in anthracycline chemotherapy of breast cancer.METHODS：A total of 102 patients with breast cancer accepting anthracycline chemotherapy were randomly divided into an experimental group with 52 patients and a control group with 50 patients.The patients in the experimental group were given hydroprednisone and glutathione by intravenous injection on the basis of conventional antiemetic drug（5-HT3 receptor antagonist-tropisetron）,and the patients in the control group were given 5-HT3 receptor antagonist-tropisetron only.The status including the reaction of digestive tract,arrest bone marrow,cardiotoxicity and hepatic damnification was observed.RESULTS：Both the incident rates of nausea,vomit and rise of hepatic glutamate alanine aminotransferase in the experimental group were significantly depressed than those in the control group by the application of hydroprednisone and glutathione（P=0.003,P=0.001）.There was no significant difference in aleucocytosis and electrocardiogram changes between the two groups（P〉0.05）.CONCLUSIONS：The hydroprednisone and glutathione can effectively reduce the incidence and extent of nausea and vomiting,and control the rise of hepatic glutamate alanine aminotransferase in anthracycline chemotherapy of breast cancer.