复方甘草酸苷防治原发性肝癌三维适形放疗后肝损伤的临床观察

目的探讨复方甘草酸苷在防治原发性肝癌（PLC）三维适形放疗（3DCRT）后肝损伤的作用。方法 113例PLC患者被随机分为治疗组62例和对照组51例,两组均采用3DCRT治疗,分割剂量为2.6～3.2Gy/次,总剂量为48～60Gy;治疗组同时给予复方甘草酸苷注射液60～100 ml/日,静脉滴注,疗程4周,再改为片剂口服,共2～3个月。结果两组患者放疗后ALT和AST较放疗前均有所升高,但治疗组ALT（51.6±12.6 U/L）和AST（48.3±14.4 U/L）升高程度明显低于对照组（分别为85.2±19.9 U/L和73.8±17.8 U/L,P〈0.01）;治疗组发生放射性肝病（RILD）4例（6.5%）,而对照组发生10例（19.6%）,治疗组明显低于对照组（P〈0.05）。结论复方甘草酸苷能预防和改善PLC患者在3DCRT治疗后的肝损伤,降低RILD的发生率。

Protective effects of compound glycyrrhizin on hepatic injury induced by three-dimensional conformal radiotherapy in patients with primary liver carcinoma

Objective To investigate the protective effects of compound glycyrrhizin on hepatic injury induced by three-dimensional conformal radiotherapy(3DCRT) in patients with primary liver carcinoma(PLC).Methods A total of 113 patients with advanced hepatocellular carcinoma were randomly divided into study group(n=62) and control group(n=51).The patients in the two groups were treated with 3DCRT,and the dose was 2.6～3.2Gy each time with the total doses of 48～60Gy;and the patients in study group were also treated with injections of compound glycyrrhizin intravenously at dose of 60ml per day for 4 weeks,then the glycyrrhizin tablets were given orally for 2～3 months.Results The levels of ALT and AST after radiation in both groups were elevated as compared with that before radiation,but the elevated levels of ALT(51.6±12.6 U/L) and AST(48.3±14.4 U/L) in the study group were significantly lower than that in the control group(85.2±19.9 U/L and 73.8±17.8 U/L,respectively,P<0.01),and the rate of radiation-induced liver disease(RILD) in the study group(4 cases,6.5%) was lower than that in the control group(10 cases,19.6%,P<0.05).Conclusion Compound glycyrrhizin can prevent and improve the hepatic injury induced by 3DCRT in patients with PLC,and it also can reduce the rate of RILD occurrence.