右丙亚胺对96例多柔比星急性心脏毒性防治作用的观察  

The observation on the protective effect of Dexrazoxane against acute cardiotoxicity induced by Doxorubicin in 96 cases

作　　者：文艺[1] 王建明[1] 王潇苓[1] 王学权[1] 黄松[1] 

机构地区：[1]攀枝花市第六人民医院(原十九冶医院),四川攀枝花617023

出　　处：《中国冶金工业医学杂志》2015年第5期501-502,共2页Chinese Medical Journal of Metallurgical industry

摘　　要：目的观察右丙亚胺对多柔比星急性心脏毒性的防治作用。方法对96例应用含多柔比星方案化疗的患者,综合心电图、血浆肌钙蛋白I、脑利钠肽水平及左心室射血分数多项指标综合监测作为观察指标,先单独化疗4个周期(多柔比星累积剂量约300mg/m2),然后将已出现观察指标异常者归入右丙亚胺治疗组、观察指标正常者分为单独化疗组及右丙亚胺联合化疗组,继续化疗2个周期,观察心脏急性毒性。结果单独化疗4个周期过程中,观察指标异常发生率为31.3%(30/96)。继续化疗2个周期,单独化疗组观察指标异常发生率为39.4%(13/33),右丙亚胺联合化疗组观察指标异常发生率为15.2%(5/33),单独化疗组急性心脏毒性发生率明显高于右丙亚胺联合化疗组(P<0.05)差异有统计学意义;右丙亚胺治疗组有26.7%患者异常观察指标转为正常,有63.3%患者异常观察指标保持稳定,只有10%患者心脏损害加重。结论右丙亚胺对多柔比星所致心脏毒性的发生有一定的防护作用,并且对已经形成的损害有一定的治疗作用。Objective To observe the protective effect of dexrazoxane on acute cardiotoxicity induced by doxorubiein.Metbods In 96 cases of chemotherapy with doxorubicin,integrated ECG, troponin I, brain natriuretic peptide levels and left ventricular ejection fraction （LVEF） were monitored as observation indexes.After chemotherapy alone for 4 cycles （doxorubicin cumulative dose about 300 mg/m2）, the cases of abnormal observation indexes were included in dexrazoxane treatment group, the cases of normal indexes were classified into chemotherapy alone group and chemotherapy combination with dexrazoxane group.All patients received 2 more cycles of chemotherapy,the incidence of acute cardiac toxicity was observed.Results The incidence rate of abnormal observation indexes was 31.3%（30/96）for 4 cycles of chemotherapy alone.Continue two cycles of chemotherapy,incidence rate of abnormal observation indexes in chemotherapy alone group was 39.4 % （13/33）, 15.2 % （5/33）in Dexrazoxane combined group.The incidence rate of acute cardiac toxicity in chemotherapy alone group were significantly higher than that in combined with dexrazoxane group （P 〈 0. 05 ）, the difference was statistically significant; there was 26.7% （8/30）patients with abnormal indicators became normal,63.3 % （19/30）patients with abnormal indicators remain stable, and only 10% （3/30） patients with heart damage worse in dexrazoxane treatment group.Conclusion Dexrazoxane has protective effect to cardiac toxicity induced by doxorubicin,and have a certain therapeutic effect on damages which have been formed.

关 键 词：右丙亚胺 多柔比星 急性心脏毒性防治 

分 类 号：R730.53[医药卫生—肿瘤]