宫颈癌化疗心脏毒性预防的研究  

A trial of prophylaxis of the cardiotoxicity of chemotherapy for cervical cancer

作　　者：段雅妮 李奇[2] 王铜 王亚楠 韩晓敏 郭中影 梁虹 周慧慧 DUAN Ya-ni;LI Qi;WANG Tong;WANG Ya-nan;HAN Xiao-min;GUO Zhong-ying;LIANG Hong;ZHOU Hui-hui(Institute of Keshan Disease, Chinese Center for Endemic Disease Control, Harbin Medical University;Department of Gynecology, Cancer Hospital of Harbin Medical University;Department of Health Education, Chinese Center for Endemic Disease Control, Harbin 150081, China)

机构地区：[1]哈尔滨医科大学中国疾病预防控制中心地方病控制中心克山病防治研究所 [2]哈尔滨医科大学附属肿瘤医院妇科 [3]哈尔滨医科大学中国疾病预防控制中心地方病控制中心健康教育处,黑龙江哈尔滨150081

出　　处：《哈尔滨医科大学学报》2018年第1期86-90,共5页Journal of Harbin Medical University

基　　金：国家自然科学基金资助项目(81372938;81773368)

摘　　要：目的评估宫颈癌化疗心脏毒性常用预防措施的效果,提出宫颈癌化疗心脏毒性预防的方案。方法干预组收集30例宫颈癌化疗患者,给予心脏毒性预防措施,包括选择化疗方案和(或)调整药量,使用心脏保护药物和调整血压,建议合理膳食和适当锻炼;对照组同期收集27例未采取预防措施的宫颈癌化疗患者。行血压、心电图和超声心动图等临床检查,测定心脏生物标志。结果两组基线资料差异无统计学意义(P>0.05)。干预后干预组cTnI、NT-proBNP、H-FABP、CK-MB、ECG较对照组有明显改善,且干预组的化疗心脏毒性水平显著低于其干预前及对照组,其中干预组与对照组Ⅰ级心脏毒性有统计学差异,干预前后患者以Ⅱ级心脏毒性有统计学差异(P<0.05);而AST、CK、HBDH、BP、SV及LVEF较对照组均无明显改善(P>0.05)。根据评估干预措施的实施效果,得出一套化疗心脏毒性预防方案。结论使用此套预防方案可以有效预防宫颈癌患者化疗产生的心脏毒性,具有较高的临床应用价值。Objective To evaluate the effect of commonly used preventive measures for cardiotoxicity induced by chemotherapy of cervical cancer,and to propose a preventive scheme of chemotherapy cardiotoxicity for cervical cancer. Methods Thirty cases of cervical cancer patients undergoing chemotherapy were collected and given preventive measures of cardiotoxicity,including chemotherapy regimen options and(or） dosage,using heart protection drugs,regulation of blood pressure,adjustment reasonable diet and healthy exercise,as the intervention group. Meanwhile,27 cases of cervical cancer patients who did not take preventive measures were enrolled,as the control group. Two groups of patients were measured blood pressure,electrocardiogram,echocardiography and cardiac biomarkers. And comparing two groups of patients with chemotherapy cardiotoxicity rate. Results There was no significant difference in the baseline data between the two groups(P〉0. 05）. The levels of c Tn I,NT-pro BNP,HFABP,CK-MB and ECG of the intervention group compared with the control group that were significantly improved. After intervention,the incidence of cardiotoxicity in the intervention group was significantly lower than that before and the control group. The incidence of I grade cardiotoxicity was significantly different between the group after intervention and the control group,while the incidence of Ⅱ grade cardiotoxicity was significantly different between the group that before and after the intervention(P〈0. 05）. The difference of AST,CK,HBDH,BP,SV and LVEF between the two groups were not significant statistically(P〉0. 05）. A set of cardiac toxicity prevention program was obtained by implementing intervention measures.Conclusion Using of this set of preventive programs can effectively prevent cardiotoxicity caused by chemotherapy in patients with cervical cancer,and it has a high clinical application value.

关 键 词：宫颈癌 化疗 心脏毒性 预防控制 心脏生物标志物 

分 类 号：R737.33[医药卫生—肿瘤] R595[医药卫生—临床医学]