《中国康复理论与实践》

《中国康复理论与实践》 ›› 2008, Vol. 14 ›› Issue (08): 754-756.

• 临床研究 • 上一篇    下一篇

还原型谷胱甘肽预防表阿霉素心脏毒性的观察

宫艳丽; 张清媛   

  1. 哈尔滨医科大学附属肿瘤医院,黑龙江哈尔滨市 150040
  • 收稿日期:2008-03-31 出版日期:2008-08-01 发布日期:2008-08-01

Prophylactic Effect of Reduced Glutathione on Cardiotoxicity Induced by Epirubicin

GONG Yan-li, ZHANG Qing-yuan   

  1. Tumor Hospital of Harbin Medical Uniuersity, Harbin 150040, Heilongjiang, China
  • Received:2008-03-31 Published:2008-08-01 Online:2008-08-01

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被引次数

24

摘要： 目的观察外源性还原型谷胱甘肽(GSH)预防表阿霉素心脏毒性的疗效。方法60例乳腺癌术后患者随机分为治疗组和对照组,各30例。治疗组接受连续6个周期CEF方案化疗+GSH治疗;对照组仅采用CEF方案化疗。化疗前、化疗3个周期及6个周期后,利用心电图、心肌酶、肌钙蛋白Ⅰ(cTnⅠ)、常规超声心动图及组织多普勒超声技术评价两组患者化疗后的心脏毒性。结果化疗3个周期后,两组患者的心电改变、cTnⅠ损伤情况、左心室射血分数(EF)、左心室短轴缩短率(FS)、二尖瓣舒张早期流速峰值/舒张晚期流速峰值(E/A)、E峰流速时间(DT)、心肌肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)等无显著性差异(P>0.05),舒张功能参数Em/Am有非常显著性差异(P<0.01)。化疗6个周期后,两组患者的EF、FS、心肌酶CK、CK-MB、LDH无显著性差异(P>0.05);心电改变、cTnI损伤情况有显著性差异(P<0.05);舒张功能参数E/A、DT、Em/Am有非常显著性差异(P<0.01)。结论GSH对表阿霉素引起的心脏毒性有防治作用,机制可能与GSH的抗氧化及抑制钙超载有关。

关键词: 还原型谷胱甘肽, 表阿霉素, 心脏毒性, 预防作用

Abstract: Objective To explore the efficacy and mechanism of exogenous reduced glutathione(GSH)on cardiotoxicity induced by epirubicin(EPI).Methods 60 postoperative patients with breast cancer were randomly divided into the treatment group and control group with 30 cases in each group.The treatment group received 6 cycles of chemotherapy with CEF regimen plus the reduced GSH.The control group also received 6 cycles of chemotherapy only with CEF alone.The cardiotoxicity of all patients were estimated by the ECG,myocardial enzymes,troponin Ⅰ(cTnⅠ),ultrasoundcardiogram and tissue Doppler technique before hemotherapy and after 3 cycles and 6 cycles of chemotherapy.Results After 3 cycles of chemotherapy,there were no significant differences in ECG,cTnⅠ,left ventricle ejection fraction(EF),fraction shortening(FS),E/A,decline time(DT)and myocardial creatine kinase(CK),isoenzyme of creatine kinase containing M and B subunits(CK-MB),lactate dehydrogenase(LDH)between two groups(P>0.05);While,there was a significant difference in Em/Am between two groups(P<0.01).After 6 cycles of chemotherapy,there were also no significant differences in EF,FS,myocardial CK,CK-MB,LDH between two groups(P>0.05);there were significant differences in ECG,cTnI,E/A,DT and Em/Am between two groups(P<0.01).Conclusion The reduced GSH can prevent the cardiotoxicicy induced by EPI,which may be related with the ability of GSH against the oxidant injury and inhibiting calcium overload.

Key words: reduced glutathione, epirubicin, cardiotoxicity, prophylactic effect