还原型谷胱甘肽用于预防和降低奥沙利铂周围神经毒性的研究

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1、还原型谷胱甘肽用于预防和降低奥沙利铂周围神经毒性的研究还原型谷胱甘肽用于预防和降低奥沙利铂周围神经毒性的研究庞丹梅，邓燕明，蓝晓珊，冯卫能，梁剑苗，徐绮华佛山市第一人民医院肿瘤内科，广东佛山528041EfficacyofreducedglutathioneinpreventingandreciucingneurotoxicityofoxaliplatinPANGDan-mei%DENGYan-ming,LANXiao-shan%FENGWei-nengtLIANGJian-mia〇tXVYi-huaDepartmentofMedicalOncology*FirstPeople*sHosp

2、italofFoshanCityyFoshan528041,P.R.China【摘要】目的：观察还原型谷胱甘肽(GSH)预防和降低奥沙利铂周围神经毒性的作用。方法：将78例肠癌术后和胃癌术后准备进行FOLFOX4或mFOLFOX6方案化疗的患者，随机分为GSH组40例和对照组38例，GSH组在奥沙利铂化疗每周期同时给予GSH1.8g/d,l次/d?加入生理盐水100mU共3d(化疗前1d、当日和第2天）。对照组在化疗每周期同时给予生理盐水100mU共3d(化疗前1d、当日和第2天>,在治疗前、化疗4个周期后、化疗8个周期后及化疗12个周期后分别记录临床感觉神经系统检查結果，并记录奥沙

3、利铂周围神经毒性级别?有神经毒性症状的患者随访1年?每3个月复查1次临床感觉神经系统检查。结果：在治疗前、化疗4个周期、化疗8GSH组与对照组的周围神经毒性发生率差异无统计学意义，F>0.05。完成12个用期化疗后GSH组3级周图神经个周期后毒性发生率为15%,4级周围神经毒性发生率为0,对照组3级周围神经毒性发生率为39.5%,4级周围神经毒性发生率为5.3%,3?4级神经毒性两组间差异有统计学意义.<0.05?随访1年后，PGSH组>2级神经毒性发生率为0,1级神经毒性发生率为7.5%(3例）；对照组>2级神经毒性发生率为0，1级神经毒性发生率为23.7%(9例

4、两组差异有统计学意义，论：化疗时使用P<0.05。结[ABSTRACT]OBJECTIVE:Toobservetheefficacyofreducedglutathioneinpreventionandreductionofoxalipatin-inductedneu-rotoxidty.METHODS:Seventy-eightpatiemsaftergasticandcohonreclalcancerresectiontreatedwithFOLFOX4ormF()LFOX6regimenwererandomizedintoreducedglutathionegroup(GSHg

5、roup)andcontrolgroup.FortypatientswereenteredinGSHgroupandthirty-eightpatientsincontrolgroup.OnedaybeforechemotherapywithoxalipJatin.thedaywithchemotherapyandthedayafterchemotherapy*theGSHgrouppatientsreceivedinfusionof1.8gofreducedglutationeintravenouslywtihNS】00niL.whilethecontrolgrouppatientsre

6、ceivedNS100mLinthethreedaywithchemotherapy.Theneurotoxityevaluationwasperformedbeforethetreatment,afterthefourthcycly?theeighthcyclyandthetwelfthcycleoftreatment.Thepatientswhohadtheneurotoxitysymptomswerefollowedupforoneyear.Theclinicalsensorynervoussystemexaminationwascheckedeverythreemonths.RES

7、ULTS：Afterthefourthandtheeiththcycle?theincidenceofneurotoxicitybetweenthetwogroupswasnotsignificantlydifferent(P>0.05).Afterthetwelfthcycle>theincidenceofgrade3and4peripheryneurotoxicityinthecontrolgroupwa