右丙亚胺用于乳腺癌术后化疗所致患者心肌损害的有效性和安全性  

Efficacy and Safety of Dexrazoxane for Chemotherapy Induced Myocardial Damage in Breast Cancer Patients after Surgery

作　　者：曹余彦 古灿基 郭锦全 

机构地区：[1]广东省广州市番禺区中心医院,511400

出　　处：《实用癌症杂志》2017年第10期1631-1634,共4页The Practical Journal of Cancer

摘　　要：目的探讨右丙亚胺对乳腺癌患者采用蒽环类化疗时心肌的保护作用。方法选择乳腺癌术后接受CAF(环磷酰胺+阿霉素+5-氟尿嘧啶)方案和TE(多西他赛+表柔比星)方案化疗的患者98例。按照随机数字法将患者分为试验组和对照组各49例。对照组及实验组均采用CAF方案和TE方案化疗,试验组在给予阿霉素或表柔比星30min前给予右丙亚胺(奥诺先)静脉滴注(右丙亚胺∶阿霉素或表柔比星=10∶1),30 min内滴完。结果与治疗前比较,试验组治疗12个月以后出现血清BNP升高,对照组治疗6个月以后出现升高,差异有统计学意义(P<0.05);治疗6个月,12个月及24个月,试验组血清BNP低于对照组,差异有统计学意义(P<0.05)。与治疗前比较,2组患者治疗6个月以后血清c Tn T升高,差异有统计学意义(P<0.05);治疗6个月,12个月及24个月,试验组血清c Tn T低于对照组,差异有统计学意义(P<0.05)。试验组患者治疗后血清CK-MB与治疗前差异无统计学意义(P>0.05);对照组治疗12个月以后升高,差异有统计学意义(P<0.05)。试验组治疗期间,LVEF与治疗前差异无统计学意义(P>0.05);对照组治疗6个月以后LVEF下降,差异有统计学意义(P<0.05);治疗6个月以后,对照组LVEF低于观察组,差异有统计学意义(P<0.05)。2组患者不良反应发生情况差异无统计学意义(P>0.05)。结论右丙亚胺用于乳腺癌术后化疗可以明显减轻蒽环类药物的心脏毒性,保护心肌细胞,且不增加化疗的不良反应,提高患者化疗药物耐受性。Objective To study the myocardial protection effect of dexrazoxane on breast cancer patients treated with an- thracycline chemotherapy. Methods 98 cases of breast cancer after operation treated with CAF （ cyclophosphamide, adriamyein 5-fluorouracil） scheme and TE （ docetaxel ＋ epirubicin） chemotherapy regimen were selected. According to the random number method, the patients were divided into the experimental group （49 cases） and the control group （49 cases）. CAF and TE regimens were used in the control group. The experimental group was given dexrazoxane（dexrazoxane： adriamycin or epirubiein = 10： 1 ） before doxorubicin or epirubicin static drop, 30 minutes to finish. Results Compared with before treatment, the experimental group after I2 months of treatment, the serum BNP increased, the control group after 6 months of treatment increased, the differ- ence was statistically significant （ P 〈 0.05 ）. For 6 months, 12 months and 24 months, the serum BNP in the experimental group was lower than that of the control group, the difference was statistically significant （ P 〈 0.05 ）. Compared with before treatment, the 2 groups were treated for 6 months after elevated cTnT, the difference was statistically significant （ P 〈 0.05 ） ; treatment of 6 months, 12 months and 24 months, Serum eTnT of the 2 groups had no statistical difference （ P 〈 0.05 ）. There was no significant difference in serum CK-MB of the experimental group compare with before treatment （P 〉 O. 05 ）, and the difference was statisti- cally significant （P 〈 0.05 ） after 12 months of treatment in the control group. During the treatment period, there was no signifi- cant difference between LVEF and treatment before treatment （ P 〉 0.05 ）, and the difference was statistically significant （ P 〈 0.05 ） in the control group after 6 months of treatment LVEF decreased. After 6 months of treatment, the control group LVEF was less than the control group, the difference was statistically signi

关 键 词：右丙亚胺 乳腺癌 蒽环类化疗药物 心肌损害 

分 类 号：R737.9[医药卫生—肿瘤]