还原型谷胱甘肽预防表阿霉素心脏毒性的观察.doc

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1、•临床硏究・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［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1（cTm）、常规超卢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

2、流速峰值/舒张晚期流速峰值（E/A）、E峰流速时间（PC、心肌肌酸激酶（CK）、肌酸激酶间工酶（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cTtii损伤悄况有显著性差异（pv°.o5）;舒张功能参数E/A、DT、Em/Am有非常显著性差异（p

3、］还原细谷胱甘肽；表阿箝索；心脏毋性；顼防作用ProphylacticEffectofReducedGlutathioneonCardioloxicityInducedbyEpirubicinGONGYanJifZHANGQing-yuan.TumorHospitalofHarbinMedicalVniuersity*Harbin150040.Heilongjiang%ChinaAbstract］ObjectiveToexploretheefficacyandmechanismofexogenousreducedglutathion

4、e(GSH)oncardiotoxicilyinducedbyepirubicin(EPI)・Methods60postoperativepatientswithbreastcancerwererandomlydividedintothetreatmentgroupandcontrolgroupwith30casesineachgroup・Thetreaimcmgroupreceived6cyclesofchemotherapywithCEFregimenplusthereducedGSH.Thecontrolgroupalsore

5、ceived6cyclesofchemotherapyonlywithCEFalone.ThecardiotoxicityofallpatientswereestimatedbytheECG»myocardialenzymes,troponinI(cTnI),ultrasoundcardiogramandtissueDopplertechniquebeforehemotherapyandafter3cyclesand6cyclesofchemotherapy・ResultsAfter3cyclesofchemotherapy»the

6、rewerenosignificantdifferencesinECGrcTnI«leftventricleejectionfraction(EF),fractionshortening(FS)»E/A.declinetime(l)T)andmyocardialcreatinekinase(CK)・isoenzymeofcreatinekinasecontainingMandBsubunits0.05)»While»therewas

7、asignifiesntdiffereneeinEm/Ambetweentwogroups(PQ.05)*thereweresignificantdifferencesinECG,cTnl,E/A.l)TandEm/Ambetweentwogroups(P<0.01).ConclusionThe

8、reducedGSHcanprevenlthecardiotoxicicyinducedbyEP1»whichmayberelatedwiththeabilityofGSHagainsttheoxidantinjuryandinhib