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1、谷胱甘肽预防恶性淋巴瘤长春新碱化疗所致神经毒性的临床硏究黄瑞霞李鑫孙振昌张蕾李玲王新华张明智摘要目的：恶性淋巴瘤发病率及死亡率逐年上升，长春新碱是治疗恶性淋巴瘤的一线化疗药物，而其突出的剂量限制性神经毒性使其临床应用明显受限。本研究旨在评价谷胱甘肽对恶性淋巴瘤长春新碱化疗所致神经毒性的预防作用。方法：100例行CHOP方案或R-CHOP方案化疗的弥漫大B细胞淋巴瘤患者，随机进入谷胱甘肽组和对照组，每2个周期评价神经毒性及近期疗效，结果：谷胱甘肽组和对照组I~II级神经毒性发生率分别为26.5%(13/49)、47.1%(24/51),111〜IV
2、级神经毒性发生率分别为6」％(3/49)、23.5%(12/51),谷胱甘肽组神经毒性发生率均低于对照组，两组差异有统计学意义(P<0.05)X)个周期后化疗有效率分别为83.7%(41/49)、82.4%(42/51),两组差异无统计学意义(P>0.05)o结论：谷胱甘肽对含长春新碱方案化疗所致的神经毒性有明显的预防作用，同时不影响化疗疗效。关键词谷胱甘肽恶性淋巴瘤长春新碱化疗神经毒性doi:10.3969/j.issn.1000-8179.2011.23.013ClinicalEfficacyofGlutathioneforPreventin
3、gVincristineNeurotoxicityduringChemotherapyforMalignantLymphomasRuixiaHUANG,XinLI,ZhcnchangSUN,LeiZHANG,LingLI,XinhuaWANG,MingzhiZHANGCorrespondenceto:XinLI,E-mail:lixiaoxin86@126.comDepartmentofMedicalOncology,TheFirstAffiliatedHospitalofZhengzhouUniversity,Zhengzhou450052,C
4、hinaAbstractObjective:Theincidenceandmortalityrateofmalignantlymphomahasarisensteadilyoverthepastdecade.Vincristineisoneofthefirst-linechemotherapeuticagentsusedfortreatingmalignantlymphoma,butdose-dependentneurotoxicitycanrestricttheclinicalapplicationofthismedicine.Thisstud
5、yaimstoaccesstheclinicalefficacyofglutathioneforpreventingvincristinc-in-duccdneurotoxicityduringchemotherapyinlymphomapatients.Methods:OnehundredmalignantlymphomapatientswhoreceivedCHOPorR-CHOPregimensincludingvincristinewererandomizedintotwogroups:theglutathionegrouptreated
6、intravenouslywithglutathionebeforechemotherapy(n=49),andthecontrolgroup(n=51)•Thedegreeofneurotoxicityandthechemotherapeuticefficacywereevaluatedeverytwotreatmentcycles.ThedegreeofneurotoxicitywasaccessedbytheWHOToxicityCriteriaScaleandthechemotherapeuticeffectwasevaluatedusi
7、ngtheChcsonCriteria.Results:TheincidencerateofgradeMIandgradeIIMVneurotoxicityafterchemotherapywassignificanUylowerintheglutathionegroupcomparedtothecontrolgroup(26.5%vs.47.1%,P<0.05;6.1%vs.21.6%,P<0.05).Incontrast,glutathionepretreatmentdidnotinfluenceclinicalefficacy,asover
8、allresponseaftersixcycleswere83.7%intheglutathionegroupand82.4%inthe
