阿霉素方案对乳腺癌患者心脏毒性的研究  

Cardiac toxicity of adriamycin on breast cancer patients

作　　者：张克兢[1] 

机构地区：[1]中南大学湘雅医院乳腺科,湖南长沙410008

出　　处：《中国现代医药杂志》2014年第12期21-23,共3页Modern Medicine Journal of China

摘　　要：目的探讨阿霉素化疗方案对乳腺癌患者心脏功能的影响。方法78例乳腺癌患者均接受含有阿霉素的治疗方案,比较治疗前后患者心电图检查、心肌蛋白检查及心脏超声检查结果。结果化疗前患者存在ST段改变者10例(12.8%)、房性早搏者3例(3.8%)、室性早搏者3例(3.8%)、窦性心律异常者7例(8.9%)、QT延长者2例(2.5%);化疗后上述心电图异常者分别为25例(32.1%)、11例(14.1%)、9例(11.5%)、19例(24.4%)、6例(7.7%),两组比较差异有统计学意义(P<0.05)。化疗前患者的平均左室射血分数为(0.91±0.19)显著高于化疗后(0.78±0.13),P<0.05;化疗前患者肌酸激酶(CK)、门冬氨酸转移酶(AST)、肌酸激酶同功酶(CK-MB)、α-羟丁酸脱氢酶(HDBH)的水平分别为(51.3±14.2)U/L、(27.1±12.5)IU/L、(8.2±2.7)U/L、(148.3±22.7)U/L分别显著低于化疗后(63.5±19.2)U/L、(33.4±13.1)IU/L、(14.5±3.9)U/L、(210.5±17.4)U/L(P<0.05)。结论含阿霉素的化疗方案显著增加了乳腺癌患者心电图异常率及心肌损伤的发生,降低了左室射血功能。Objective To investigate the effect of adriamycin chemotherapy regimen on cardiotoxicity of patients with breast cancer. Methods 78 cases of breast cancer patients were treated with adriamycin chemotherapy. Compared the results of ECG, myocardial protein examination and echocardiography before and after treatment. Results Before chemotherapy, 10 cases （12.8%） had ST segment changes,3 cases （3.8%） had atrial premature beat, 3 cases （3.8%） had ventricular premature beat,7 cases （8.9%） had abnormal sinus rhythm,QT of 2 patients （2.5%） was prolonged; the number of cases with abnormal electrocardiogram after chemotherapy was 25 cases （32.1% ）, 11 cases （ 14.1% ）, 9 cases （ 11.5%）, 19 cases （24.4%）, 6 cases （7.7%） respectively, there was significant difference between the two groups （P〈0.05）. Before chemotherapy,the average left ventricular ejection fraction was （0.91±0.19）,which was significantly higher than that after chemotherapy （0.78±0.13） ,P〈O.05. Before chemotherapy, the level of creatine kinase （CK）, aspartate aminotransferase （AST）, creatine kinase isoenzyme （CKMB）, alpha hydroxybutyrate dehydrogenase （HDBH） was （51.3±14.2） U/L, （27.1 ±12.5 ）IU/L, （8.2±2.7） U/L, （148.3±22.7） U/L respectively,which was significantly lower than that after chemotherapy （63.5±19.2）U/L, （33.4±13.1）IU/L, （14.5±3.9）U/L, （210.5±17.4）U/L （P〈0.05）. Conclusion Chemotherapy with adriamycin significantly increases the occurrence rate of abnormal electrocardiogram and myocardial injury for patients with breast cancer, reduces left ventricular ejection function.

关 键 词：阿霉素 乳腺癌 不良反应 

分 类 号：R737.9[医药卫生—肿瘤]