磷酸肌酸对蒽环类抗生素心脏毒性保护作用的Meta分析  

Meta analysis of the protective effect of phosphocreatine on cardiotoxicity induced by anthracycline

作　　者：陈健康 王春光[1] CHEN Jian-kang;WANG Chun-guang(Oncology Department,Yongchuan Hospital of Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院肿瘤科,重庆402160

出　　处：《临床医学研究与实践》2018年第34期8-11,共4页Clinical Research and Practice

基　　金：重庆医科大学附属永川医院青年课题(No.YJQN2011032)

摘　　要：目的系统评价磷酸肌酸对蒽环类抗生素心脏毒性的保护作用,旨在为临床用药提供循证依据。方法计算机检索Pubmed、Embase、Cochrane Library、中国知网、万方及维普数据库,收集磷酸肌酸用于预防蒽环类抗生素导致的心脏毒性的随机对照研究(RCT)文献。由两名研究者单独进行,并严格按照纳入及排除标准进行文献筛选,采用RevMan5.3统计软件进行Meta分析。结果最终纳入9篇RCT,共858例患者,其中试验组442例,对照组416例。Meta结果分析显示,试验组的心脏毒副反应发生率(OR=0.19,95%CI:0.08～0.48,P=0.0004)、心酶异常率(OR=0.06,95%CI:0.03～0.12,P<0.00001)及心电图异常率(OR=0.33,95%CI:0.20～0.53,P<0.00001)均显著低于对照组,提示磷酸肌酸在蒽环类抗生素化疗时对于心脏的保护作用效果显著。结论在使用蒽环类抗生素进行化疗时,加用磷酸肌酸可降低心脏毒副反应发生率、心酶异常率及心电图异常率,从而可有效的保护心脏功能不受药物影响。Objective To systematically evaluate the protective effect of phosphocreatine on cardiotoxicity induced byanthracycline, in order to provide evidence-based basis for clinical medication. Methods Using computer to retrieve Pubmed,Embase, Cochrane Library, Chinese know net, Wanfang and VIP database, the randomized controlled trial （RCT） literaturesabout the role of phosphocreatine in preventing cardiotoxicity induced by anthracycline were collected. Two researchersindependently screened literatures according to inclusion and exclusion criteria. The RevMan5.3 statistical software was used formeta analysis. Results Finally, 9 RCT literatures were included, including 858 patients, and there were 442 cases in theexperimental group and 416 cases in the control group. Meta-analysis results showed that the incidence of cardiac toxicity andside effects（OR=0.19, 95%CI： 0.08-0.48, P=0.0004）, abnormal rate of cardiac enzymes（OR=0.06, 95%CI： 0.03-0.12, P〈0.00001）and abnormal rate of electrocardiogram （OR =0.33, 95%CI： 0.20 -0.53, P〈0.00001） in the experimental group weresignificantly lower than those in the control group, which suggested that the effect of phosphocreatine on heart protectionduring anthracycline chemotherapy was remarkable. Conclusion Phosphocreatine can reduce the incidence of cardiactoxicity and side effects, the abnormal rate of cardiac enzymes and electrocardiogram during anthracycline chemotherapy,thus it can effectively protect cardiac function from drug effects.

关 键 词：磷酸肌酸 蒽环类抗生素 化疗性心脏毒性 随机对照研究(RCT) META分析 

分 类 号：R595.3[医药卫生—内科学]