摘要
目的观察右丙亚胺(DEX)对白血病、淋巴瘤、女性早中期乳腺癌术后接受蒽环类药物化疗所致心脏毒性的预防作用。方法将60例化疗的恶性肿瘤病人(白血病30例,恶性淋巴瘤20例,乳腺癌10例)分为DEX组和对照组,各30例。两组病人均接受以蒽环类药物为基础的化疗方案6周期,DEX组在使用蒽环类药物化疗的同时加用右丙亚胺(10∶1)预防心脏毒性。观察两组心肌肌钙蛋白I(cTnI)、左室射血分数(LVEF)、心电图变化,室性心律失常的发生率及3级～4级的毒性和总的毒性。结果 DEX组化疗1周期～6周期cTnI明显低于对照组,差异有统计学意义(P <0.05);DEX组化疗前后LVEF比较,差异无统计学意义(P>0.05),对照组化疗后LVEF较化疗前显著下降,差异有统计学意义(P <0.05),两组化疗后LVEF比较差异有统计学意义(P <0.05);DEX组心电图异常率为6.67%,对照组心电图异常发生率为30.00%,两组比较差异有统计学意义(P <0.05);DEX组室性心律失常发生率为0.00%,低于对照组的20.00%,差异有统计学意义(P <0.05);两组病人3级～4级的毒性和总的毒性比较差异无统计学意义(P>0.05)。结论右丙亚胺对蒽环类药物所致心脏毒性的发生有明显预防作用,并且对已形成的心脏损害有一定的治疗作用,不良反应少。
Objective To observe the preventive effect of dextroimine （DEX） on cardiotoxicity induced by anthracycline chemotherapyn patients with leukemia,lymphoma,and female early stage breast cancer.Methods Sixty patients with malignant tumors undergo -ng chemotherapy,including 30 cases of leukemia,20 cases of malignant lymphoma,10 cases of breast cancer,were randomly dividednto two groups：control group （ n =30） treated with routine treatment,and DEX group （ n =30） treated with DEX in the basis of anthra -cycline based chemotherapy regimen for 6 cycles.The cardiac troponin I （cTnI）,left ventricular ejection fraction （LVEF）,electrocardio -gram （ECG） changes,the incidence of ventricular arrhythmias,and the toxicity and total toxicity of grade 3 to grade 4 were measured.Results The cTnI level in DEX group was significantly lower than that in control group from 1 to 6 cycles （P 〈0.05）.LVEF in controlgroup after chemotherapy was significantly lower than that before chemotherapy （P 〈0.05）.There was a statistically significant differ -ence in LVEF between two groups after chemotherapy （P 〈0.05）.The abnormal rate of ECG was 6.67% in the DEX group,and 30.00% inhe control group the difference was statistically significant （P 〈0.05）.The incidence of ventricular arrhythmia in the DEX group was〈lower than that in the control group （0.00% vs 20.00%, P 〈0.05）.There was no significant difference in toxicity and total toxicity ofgrade 3 to grade 4 between two groups （P 〉0.05）.Conclusion Dexrazoxane has the obvious preventive effect on the cardiotoxicitycaused by anthracyclines,and has a certain therapeutic effect on the cardiac damage with fewer adverse reactions.
作者
买泓
吴春农
Mai Hong;Wu Chunnong(The First People ′ s Hospital of Liangshan Yi Autonomous Prefecture Liangshan 615000,Sichuan,China)
出处
《中西医结合心脑血管病杂志》
2018年第17期2542-2545,共4页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
关键词
恶性肿瘤
右丙亚胺
蒽环类药物
心脏毒性
肌钙蛋白I
左室射血分数
malignant tumor
dexrazoxane
anthracycline
cardiotoxicity
cardiac troponin I
left ventricular ejection fraction
