Abstract:

Objective　To observe the clinical effect of reduced glutathione on reducing oxidative stress and hepatotoxicity in patients with liver cancer undergoing chemotherapy. Methods　One hundred and three patients with liver cancer admitted to Shangqiu First People's Hospital from March 2020 to August 2021 were selected for the prospective study. They were divided into an observation group (52 cases) and a control group (51 cases) by drawing lots. In the observation group, there were 30 males and 22 females; they were (60.44±5.25) years old. In the control group, there were 31 males and 20 females; they were (61.25±5.47) years old. Both groups received chemotherapy uniformly. The observation group used reduced glutathione as the adjuvant chemotherapy. The changes of liver function and oxidative stress reaction between the two groups before and after the treatment were compared. All the patients were followed up for one year after the treatment. The incidences of chemotherapy related complications and survival rates were compared between the two groups. The data were compared between these two groups by χ² and t tests. Results　Before the treatment, there were statistical differences in liver function and oxidative stress reaction between the two groups (all P>0.05). After the treatment, the levels of glutamic oxaloacetic transaminase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), malondialdehyde (MDA), and catalase (CAT) in the observation group were lower than those in the control group [(50.25±5.33) U/L vs. (53.44±5.17) U/L, (50.16±5.23) U/L vs. (53.11±5.16) U/L, (30.22±5.14) μmol/L vs. (33.16±5.33) μmol/L, (4.88±0.24) nmol/L vs. (5.02±0.33) nmol/L, and (72.33±5.27) Ku/L vs. (75.31±5.62) Ku/L], with statistical differences (t=3.082, 2.850, 2.881, 2.466, and 2.777; all P<0.05); the level of superoxide dismutase (SOD) in the observation group was higher than that in the control group [(325.44±10.27) U/L vs. (319.42±10.36) U/L; t=2.962, P=0.004]. During the follow-up, the incidence of chemotherapy related complications in the observation group was lower than that in the control group [5.77% (3/52) vs. 19.61% (10/51); χ²=4.471, P=0.035]; the scores of living quality (QLQ-C30) and life quality (QLQ-HCC) in the observation group were lower than those in the control group [(57.73±5.28) vs. (60.12±5.32) and (22.47±3.15) vs. (24.15±3.44); t=2.288 and 2.586, P=0.024 and 0.011]. Conclusion　Reduced glutathione adjuvant chemotherapy can reduce the oxidative stress reaction and liver function damage in patients with liver cancer, and has positive significance in reducing the risk of chemotherapy related complications and improving the living and life qualities.

Key words:

Liver cancer, Chemotherapy, Reduced glutathione, Oxidative stress reaction, Hepatotoxicity

摘要：

目的　观察还原型谷胱甘肽（GSH）对减轻肝癌化疗患者氧化应激反应及肝脏毒性的临床效果。方法　本文为前瞻性研究，病例纳入商丘市第一人民医院2020年3月至2021年8月期间收治的103例肝癌患者，采用抽签法将其分为观察组（52例）和对照组（51例）。观察组中男30例、女22例，年龄（60.44±5.25）岁；对照组中男31例、女20例，年龄（61.25±5.47）岁。两组均统一接受化疗，观察组加用GSH辅助化疗，比较两组患者治疗前后的肝功能、氧化应激反应变化情况。治疗后对所有患者开展为期1年随访，比较两组化疗相关并发症发生情况及生存情况。组间比较采用χ²检验、t检验进行统计分析。结果　治疗前，两组患者的肝功能、氧化应激反应指标差异均无统计学意义（均P>0.05）；治疗后，观察组的天冬氨酸转氨酶（AST）为（50.25±5.33）U/L、丙氨酸转氨酶（ALT）为（50.16±5.23）U/L、总胆红素（TBil）水平为（30.22±5.14）μmol/L、丙二醛（MDA）为（4.88±0.24）nmol/L、过氧化氢酶（CAT）为（72.33±5.27）Ku/L，均低于对照组［（53.44±5.17）U/L、（53.11±5.16）U/L、（33.16±5.33）μmol/L、（5.02±0.33）nmol/L、（75.31±5.62）Ku/L］，两组比较，差异均有统计学意义（t=3.082、2.850、2.881、2.466、2.777，均P<0.05）；观察组的超氧化物歧化酶（SOD）为（325.44±10.27）U/L，高于对照组的（319.42±10.36）U/L（t=2.962，P=0.004）。随访期间，观察组的化疗相关并发症发生率为5.77%（3/52），低于对照组19.61%（10/51）（χ²=4.471，P=0.035）；观察组肝癌患者生活质量（QLQ-C30）评分（57.73±5.28）分、生命质量（QLQ-HCC 18）评分（22.47±3.15）分，均低于对照组［（60.12±5.32）分、（24.15±3.44）分］（t=2.288、2.586，P=0.024、0.011）。结论　采用GSH辅助化疗可减轻肝癌患者的氧化应激反应及肝功能损伤，对降低化疗相关并发症发生风险并提升生活质量、生存质量均有积极意义。

关键词:

肝癌, 化疗, 还原型谷胱甘肽, 氧化应激反应, 肝脏毒性