全身化疗同步应用谷胱甘肽对转移性肝癌肝脏功能的保护作用及安全性分析

Effect of simultaneous chemotherapy of systemic chemotherapy with glutathione on hepatic function in patients with metastatic liver cancer and its safety analysis

目的探究全身化疗同步应用谷胱甘肽对转移性肝癌病人肝脏功能的保护作用及其安全性。方法选取2015年1月到2017年10月合肥市第二人民医院收治的转移性肝癌病人40例,所有病人均接受全身化疗,按照随机数字表法将病人分为对照组20例,采用同步常规对症治疗;观察组20例,在对照组病人治疗的基础上联合还原型谷胱甘肽静脉滴注治疗。所有病人在院均行影像学、肝功能等相关检查,化疗2程后再次检查相关指标,比较两组治疗前后临床症状改善情况、肝功能差异以及不良反应发生情况。结果观察组上腹不适好转率(90.0%)、消化功能紊乱好转率(95.00%)、乏力好转率(90.00%)以及纳差好转率(95.00%)均明显高于对照组(55.00%、65.00%、60.00%、60.00%),差异有统计学意义(P<0.05)。两组治疗前血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)、总胆红素(TBil)水平均差异无统计学意义(P>0.05)。经过不同方案治疗后,观察组病人ALT(20.20±10.46)U/L、AST(27.90±20.48)U/L、GGT(84.80±67.48)U/L、TBil水平(15.00±8.06)μmol/L明显低于治疗前[(26.20±6.70)U/L、(40.05±17.22)U/L、(128.25±66.63)U/L、(15.27±7.04)μmol/L],均差异有统计学意义(P<0.05)。观察组病人血清ALT、AST、GGT水平改善总有效率明显高于对照组,差异有统计学意义(P<0.05);两组病人TBil改善效果差异无统计学意义(P>0.05)。结论全身化疗同步应用谷胱甘肽对转移性肝癌病人肝脏功能的保护作用显著,且使用安全,提升化疗依从性,使生存获益,值得在临床推广应用。

Objective To investigate the protective effect and safety of systemic chemotherapy and concurrent application of glutathione on liver function in patients with metastatic liver cancer.Methods The study participants selected 40 patients with metastatic liver cancer who were admitted to the Second People’s Hospital from January 2015 to October 2017.All patients were received systemic chemotherapy.20 patients with synchronous conventional hepatoprotective therapy were selected as the control group and 20 patients were in the control group.On the basis of treatment,patients treated with combined reduction of glutathione were treated as observation groups.All patients were hospitalized for iconography,liver function and other related examinations,and related indicators were examined again after twocycles of chemotherapy.The improvement of clinical symptoms,differences in liver function, and occurrence of adverse reactions before and after treatment were compared between the two groups.Results The improvement rate of upper abdominal discomfort (90.0% vs. 55.00%),disorders of digestion(95.00% vs. 65.00%),fatigue(90.00% vs. 60.00%) and(95.00% vs. 60.00%)nadir were all significantly higher in the observation group than in the control group.The difference was statistically significant (P<0.05).There was no significant difference in serum ALT,AST,GGT and TBil levels before treatment between the two groups(P>0.05).After treatment with different regimens,the levels of ALT[(20.20±10.46)U/L vs.(26.20±6.70)U/ L],AST[(27.90±20.48)U/L vs.(40.05±17.22)U/L],GGT[(84.80±67.48)U/L vs.(128.25±66.63)U/L],and TBil [(15.00±8.06)μmol/L vs.(15.27±7.04)μmol/L]in the observation group were significantly lower than before treatment.Statistically significant(P< 0.05).After hepatoprotective therapy with different regimens,the total effective rate of serum ALT,AST,and GGT levels in the observation group was significantly higher than that in the control group(P<0.05).The improvement effect of TBil in the two groups was not statistically significant(P>0.05).Conclusion The simultaneous application of systemic chemotherapy to glutathione has a significant protective effect on hepatic function in patients with m,which is worthy of clinical application.