蒽环类药物心脏毒性分析及临床使用建议  

Analysis of cardiotoxicity of Anthracyclines and relevant proposals for their clinical use

作　　者：王琳[1] 杨雪[1] 肖玲芳[1] 胡长平[2] 龚志成[1] 

机构地区：[1]中南大学湘雅医院药学部,湖南长沙410008 [2]中南大学药学院,湖南长沙410078

出　　处：《中国现代医学杂志》2017年第12期101-105,共5页China Journal of Modern Medicine

基　　金：中南大学研究生创新项目(No:2016zzts528);湖南省科技计划项目(No:2015SK2035)

摘　　要：目的探讨蒽环类药物心脏毒性的预防、缓解措施,为其临床合理应用提供参考。方法对360例恶性肿瘤患者使用蒽环类药物化疗后,分析其心电图及心脏保护药使用情况,比较右丙亚胺单独使用、二丁酰环磷腺苷钙针和磷酸肌酸钠合用的心脏保护疗效。结果蒽环类药物心脏毒性发生率为11.2%,结果显示,右丙亚胺单独使用、二丁酰环磷腺苷钙针和磷酸肌酸钠合用对蒽环类药物心脏毒性有保护作用,2种心脏保护方案对蒽环类药物心脏毒性保护的疗效比较,差异无统计学意义(P>0.05)。结论蒽环类药物有致心脏毒性的作用,在化疗过程中对患者心脏功能进行监测、合理使用心脏保护药物是预防或减缓心脏毒性的有效方法。Objective To discuss the measures of prevention and mitigation of cardiotoxicity caused by Anthracyelines, so as to provide reference for reasonable clinical application. Methods A total of 360 patients with malignant tumors were enrolled in the study. The results of electrocardiogram （ECG） and the use of cardioprotective drugs were analyzed when the patients were treated with Anthracycline chemotherapy. There were two heart protection schemes in the study, i.e. single use of Dexrazoxane, and combined use of Calcium Dibutyryladenosine Cyclophosphate and Sodium Phosphocreatine. Their protective effect on heart was compared by chi-square analysis. Results The incidence of cardiac toxicity induced by Anthracyelines was 11.2%. Chi- square analysis showed that the heart protection effect of the two schemes was remarkable, but there was no significant difference between the two heart protection schemes （P 〉 0.05）. Conclusions Anthracyclines may cause serious eardiotoxicity. Monitoring of cardiac function and appropriate use of cardioprotective drugs in the treatment are effective methods to prevent or slow down cardiac toxicity.

关 键 词：蒽环类药物 心脏毒性 心电图 心脏保护 

分 类 号：R969.3[医药卫生—药理学]