右丙亚胺联合参麦注射液用于蒽环类药物致乳腺癌患者心脏毒性的临床观察  

Clinical Observation of the Reduction of Anthracycline-induced Cardiotoxicity in Patients with Breast Cancer by Dexrazoxane Combined with Shenmai Injection

作　　者：余炜[1] 郭增清[2] 谢瑞祥[1] 范芳[1] 

机构地区：[1]福建省肿瘤医院药剂科,福州350014 [2]福建省肿瘤医院肿瘤内科,福州350014

出　　处：《中国药房》2015年第32期4562-4564,共3页China Pharmacy

摘　　要：目的:观察右丙亚胺联合参麦注射液用于蒽环类药物致乳腺癌患者心脏毒性的疗效及安全性。方法:选取女性乳腺癌患者120例,按随机数表法分为A、B、C、D组,各30例。A组患者给予环磷酰胺75 mg/m2+氟尿嘧啶500 mg/m2+阿霉素60 mg/m2(CAF)方案化疗,ivgtt;B组患者在CAF方案基础上给予参麦注射液50 ml,qd,ivgtt;C组患者在CAF方案基础上给予右丙亚胺60mg/m2,化疗前30 min快速ivgtt;D组患者在CAF方案基础上给予等剂量右丙亚胺联合参麦注射液治疗。3周为1个周期,共化疗4个周期。观察化疗前后患者心电图变化、左室射血分数(LVEF)、心肌肌钙蛋白T(cTnT)、B型利钠肽(BNP)及骨髓抑制反应发生率情况。结果:治疗后,B、C、D组患者心电图异常率、LVEF值、cTnT值、BNP值较A组均有显著性改善,差异有统计学意义(P<0.05);D组患者与B、C组比较,上述指标均有显著性改善,差异有统计学意义(P<0.05);患者骨髓抑制反应发生率D组<C组<B组<A组,组间比较差异均有统计学意义(P<0.05)。结论:右丙亚胺联合参麦注射液用于蒽环类药物致乳腺癌患者心脏毒性有良好的效果且安全性较好。OBJECTIVE： To observe therapeutic efficacy and safety of dexrazoxane combined with Shenmai injection in the treatment of anthracycline-induced cardiotoxicity in patients with breast cancer. METHODS： 120 female breast cancer patients were randomly divided into group A, B, C and D with 30 cases in each group. Group A was given CAF chemotherapy plan （cyclophos- phamide 75 mg/m2＋fluorouracil 500 mg/m2 ＋ doxorubicin 60 rag/m2）, ivgtt; group B was additionally given Shenmai injection 60 ml, qd, ivgtt, on the basis of CAF plan; group C was additionally given rapid intravenous of dexrazoxane 60 mg/m2 30 rain before chemotherapy, on the basis of CAF ; group D was additionally given constant dose of dexrazoxane combine with Shenmai injection on the basis of CAF plan. A treatment course lasted for 3 weeks, they were given 4 courses in total. The change of ECG, LVEF, cTnT and BNP and the incidence of bone marrow suppression were observed before and after chemotherapy. RESULTS： After treat- ment, the rate of abnormal ECG, LVEF value, cTnT value and BNP value of groups B, C and D were all decreased significant- ly, with statistical significance （P〈0.05）. Compared with group D, above index of groups B and C were decreased significantly, with statistical significance （P〈0.05）. The incidence of bone marrow suppression was in ascending order, group D〈group C〈group B〈groupA, with statistical significance （P〈0.05）. CONCLUSIONS： Dexrazoxane combined with Shenmai injection is effective and safe in the treatment of anthracycline-induced cardiotoxicity in patients with breast cancer.

关 键 词：右丙亚胺 参麦注射液 乳腺癌 心脏毒性 

分 类 号：R737.9[医药卫生—肿瘤]