鼻咽癌患者外周血血浆可的松水平和全血还原型谷胱甘肽含量的昼夜节律(英文)  

Circadian Variation of Plasma Cortisol and Whole Blood Reduced Glutathione Levels in Nasopharyngeal Carcinoma Patients

作　　者：吴明玮[1] 曾昭蕾[1] 李苏[1] 郭灵[1] 张晋昕[2] 邱枋[1] 冼励坚[1] 

机构地区：[1]华南肿瘤学国家重点实验室 [2]中山大学医学统计与流行病学系,广东广州510080

出　　处：《癌症》2008年第3期237-242,共6页Chinese Journal of Cancer

基　　金：卫生部临床重点学科基金(No.20014056)~~

摘　　要：背景与目的:谷胱甘肽与细胞对抗癌药物的解毒作用以及对放射性损伤的保护机制密切相关。本文通过对鼻咽癌患者和健康志愿者外周血血浆可的松水平和全血还原型谷胱甘肽含量的昼夜节律进行研究,从而为鼻咽癌患者进行肿瘤的时间治疗提供参考资料。方法:13名鼻咽癌患者(实验组)和14名健康志愿者(正常对照组)参加本项研究。每位受试者均从中午12点开始抽取外周静脉血4.5mL,每隔4h抽血一次,在24h内共抽血6次。血浆可的松水平的检测采用放射免疫法,全血还原型谷胱甘肽含量则采用高效液相色谱法进行检测。结果:鼻咽癌患者组和正常对照组的血浆可的松水平均呈现出明显的昼夜节律的特征,且节律特性相似。两组的血浆可的松水平的峰值均出现在早晨,而谷值均出现在午夜。不同时间点时,两组的全血还原型谷胱甘肽含量不同,且均具有显著性差异(重复测量的方差分析,F=5.18,P=0.02)。余弦分析表明,鼻咽癌患者组呈现出昼夜节律变化趋势(P=0.06),峰值出现在早晨(05∶02),正常对照组也呈现出明显的昼夜节律的特征,峰值出现在早晨(07∶44±01∶56)(P<0.01)。鼻咽癌患者组外周全血中还原型谷胱甘肽的节律调整均值为(19.60±1.11)nmol/mgprotein,正常对照组为(8.95±0.46)nmol/mgprotein。结论:包括晚期患者在内的鼻咽癌患者仍然具有正常的生物节律。鼻咽癌患者全血中还原型谷胱甘肽水平呈现出昼夜节律变化的趋势,与正常对照组节律特性相似。这为临床上选择恰当的时间对患者进行化疗和放疗提供了有价值的参考资料。BACKGROUND ＆ OBJECTIVE： Glutathione is involved in cellular protection against radiation damage and drug detoxification. This study was to investigate the circadian variation of plasma cortisol and whole blood reduced glutathione （GSH） levels in nasopharyngeal carcinoma （NPC） patients to provide references for chronotherapy for NPC. METHODS： A total of 13 NPC patients and 14 healthy volunteers were involved. Peripheral venous blood was sampled every 4 h during one 24- hour period starting at 12：00 am. The plasma cortisol concentration was determined by radioimmunoassay; the GSH concentration was determined by high performance liquid chromatography. RESULTS： Plasma cortisol levels of both groups displayed clear and similar circadian rhythms. The cortisol level peaked in both groups in the morning and was the lowest at mid-night. In both groups, GSH concentrations showed significant differences according to sampling time （ANOVA for Repeated Measures, F=5.18, P= 0.02）. By cosinor analysis, the circadian variation of the GSH level in NPC group was marginally statistically significant （Cosinor analysis, P=0.06） with the acrophase appeared at 05：02; the GSH level in control group displayed an obvious circadian rhythm and the acrophase appeared at 07：44±01：56 （P〈0.01）. The rhythm-adjust mean value of glutathione was （19.60±1.11） nmol/mg protein in NPC group and （8.95±0.46） nmol/mg protein in control group. CONCLUSIONS： The circadian rhythm of the plasma cortisol level is maintained in NPC patients, even in some patients at advanced stages. In NPC patients, GSH shows a trend of circadian variation which is similar to that in healthy controls. These results could be used to select special schedules for chrono-radiotherapy and chrono-chemotherapy for NPC patients.

关 键 词：时间治疗 昼夜节律 可的松 谷胱甘肽 鼻咽肿瘤 

分 类 号：R739.63[医药卫生—肿瘤]