谷氨酰胺预防新辅助化疗导致肠道损伤的前瞻性、随机研究  

Prophylatic oral glutamine ameliorates neoadjuvant chemotherapy-induced intestinal injury: a prospective, randomized study

作　　者：李幼生[1] 黎介寿[1] 于泽平[1] 刘放南[1] 谭力[1] 王卫红[1] 

机构地区：[1]南京军区南京总医院解放军普通外科研究所,江苏南京210002

出　　处：《肠外与肠内营养》2003年第1期24-27,31,共5页Parenteral & Enteral Nutrition

摘　　要：目的 :观察口服谷氨酰胺对化疗导致肠道损伤的保护作用。　方法 :本研究为前瞻性随机研究。将接受新辅助化疗的 39例乳腺癌病人随机分为两组。对照组 (n =2 0 )化疗时不口服谷氨酰胺 ;实验组 (n =19)化疗同时口服谷氨酰胺 (30 g/d) ,两组病人均行CEF(环磷酰胺 ,表阿霉素 ,5 FU)方案化疗。化疗前和化疗后观察并记录化疗不良反应 ,测定血浆谷氨酰胺浓度和肠道通透性。　结果 :化疗后实验组血浆谷氨酰胺浓度明显高于对照组 ,为(4 15 .4 5± 6 8.0 1)mmol/Lvs (30 2 .83± 5 1.98)mmol/L(P <0 .0 5 ) ;而肠道通透性增加明显低于实验组 ,为 0 .0 4 93± 0 .0 0 94vs 0 .0 6 31± 0 .0 12 0 (P <0 .0 5 ) ,两组病人毒性、口腔炎、腹泻及化疗后肿瘤体积变化均无显著差异。　结论 :口服谷氨酰胺能够减轻化疗导致的乳腺癌病人肠道通透性增加 ,但对化疗引起的毒性、口腔炎和腹泻等不良反应无保护作用 ,口服谷氨酰胺也不影响肿瘤对新辅助化疗的反应。Objectives:To investigate the effect of prophylatic oral glutamine on the neoadjuvant chemotherapy induced intestinal injury. Methods: Thirty nine patients with breast cancer were divided into two group. Nineteen patients with breast cancer received oral glutamine (30 g/d) on days of neoadjuvant chemotherapy adminstration and for at least 12 days, and twenty patient without glutamine as control. All patients received neoadjuvant chemotherapy(Cyclophosphamide,Epirubicin,Fluorouracil).The toxicity, stomatitis and diarrhea were scored according to the World Health Organization and National Institute of Health classification. The plasma glutamine level and intestinal permeability were analyzed. Results: No differences between two groups were observed in the grades of toxicity, stomatitis, diarrhea and tumor size.The plasma glutamine level was significantly higher in study group compared with control group( P <0.05),and intestinal permeability was signifcantly lower in study group compared with control group( P <0.05). Conclusions: Prophylatic oral glutamine could ameliorate the neoadjuvant chemotherapy induced increase in intestinal permeability but had no significant positive clinical effect on toxicity, stomatitis and diarrhea.

关 键 词：预防 肠道损伤 谷氨酰胺 化疗 不良反应 肠道通透性 

分 类 号：R730.53[医药卫生—肿瘤]