Clinical Research Of The Effects On Liver Injury Induced By Chemotherapy In Patients With Breast Neoplasm: Reductive Glutathione VS Compound Ammonium Glycyrrhizin

Objective:To investigate the clinical efficacy and value of reductive glutathione(GSH) and compound ammonium glycyrrhizin(CAG) on liver injury induced by chemotherapy in patients with breast neoplasm.Methods:Collection data of patients with breast neoplasm who are cured by epirubicin and docetaxel in department of mammary and thyroid surgery of Shandong Provincial Hospital affiliated to Shandong University, from January 2009 to December 2010, of which 241 cases were all primary breast neoplasm and completed surgery. In addition to the hepatic protective drug,the application of other drugs are all the same.Patients were divided into two groups arrording to the difference of the hepatic protective drug.There were 73 patients in group A who used GSH thirty minutes before chemotherapy from the first day and lasted 3 days.There were 168 patients in group B who used CAG before chemotherapy from the first day to the third day.The dose is 1.5g per day in group A and 60ml per day in group B.The result were analyzed through the comparison of the rate of the hapatic indury,the variance of alanine aminotransferase(ALT), aspartate aminotrans-ferase(AST), alkaline phosphatase(ALP), total bilirubin(TBIL),the distribution of hepatic damage,the first time the hepatic indury occurred and the rate of patients who delayed the chemotherapy caused by damaged liver function.Results:1. Clinical efficacy:The rate of hepatic indury in group A is 37.0%, higher than the rate in group B (31.0%), but the difference was not significant (P> 0.05). The values of ALT,AST,ALP and TBIL fluctuated greater in group B than those in group A after 4 cycles of chemotherapy, but the difference was not significant (P>0.05). The distribution of the hepatic indury degree showed no significant difference between two groups(P>0.05). The difference of patients who delayed the chemotherapy due to the hepatic indury showed no statistically significant (P>0.05).2. Pharmacoeconomic analysis results:the cost of the patients in group A was 776.70 yuan in contrast to the 846.40 yuan in group B. By the minimum cost analysis and sensitive analysis,GSH obtained the economic advanta-ges.ConclusionsrThe difference of the clinical efficacy between GSH and CAG was not significant.Due to the economic advantage, GSH has good foreground for the clinical application.