表阿霉素对合并糖尿病的早期乳腺癌患者心率变异性影响  

Effects of Epirubicin-Based Chemotherapy on Cardiac Autonomic Nervous System Activity in Breast Cancer Patients with Diabetes

作　　者：孙芳毅[1] 施靖[1] 王红芳 马景涛[1] 

机构地区：[1]河北医科大学第四医院,河北石家庄050011 [2]河北中医学院药学院,河北石家庄050200

出　　处：《肿瘤学杂志》2017年第11期992-995,共4页Journal of Chinese Oncology

摘　　要：[目的]分析合并糖尿病的女性早期乳腺癌患者应用表阿霉素化疗后心脏自主神经系统活性变化。[方法]入选52例合并2型糖尿病、52例不合并2型糖尿病的女性早期乳腺癌患者,均行表阿霉素+环磷酰胺化疗。入选年龄匹配无乳腺癌的2型糖尿病女性患者50例作为糖尿病对照组。所有患者均行体格检查,包括身高、体重、血压、血常规及血脂、血糖、同步12导联心电图和24小时动态心电图检查。[结果]糖尿病患者在化疗前基线水平,SDNN、SDANN、RMSSD、p NN50、LF、HF明显降低,LF/HF比值明显升高;而在化疗后,糖尿病患者组与非糖尿病化疗组及糖尿病对照组比较,HRV各项指标的恶化更明显。[结论]对于合并糖尿病的早期乳腺癌患者,应用表阿霉素化疗后,明显的进一步加重了心脏自主神经系统损伤。[Objective] To investigate the effects of epirubicin-based chemotherapy on cardiac autonomic nervous system（ANS） activity in breast cancer patients with type 2 diabetes mellitus （DM2）. [Methods] 52 female early stage breast cancer patients with DM2 and 52 age-matched female early stage breast cancer patients without DM2 were recruited to receive the chemotherapy（epirubicin and cyclophosphamide）. 50 age-matched female DM2 patients without breast cancer patients were recruited as controls. All patients received physical examination,including measurement of height,weight and blood pressure,a resting 12-lead electrocardiogram and 24-hour dynamic electrocardiogram. [Results] The baseline of SDNN,SDANN,RMSSD,pNN50,LF,HF before chemotherapy in DM2 patients were lower significantly,LF/HF was higher significantly. However,after chemotherapy,compared to NDM patients and DM2 patients in control,in DM2 patients,the exacerbation of HRV got more significant. [Conclusion] This study showed that patients with DM2,epirubicin-based chemotherapy lead to further aggravated autonomic nerve dysfunction.

关 键 词：表阿霉素 乳腺癌 糖尿病 心脏毒性 心率变异性 

分 类 号：R737.9[医药卫生—肿瘤]