心肌灌注显像联合心肌酶监测含蒽环类药物治疗乳腺癌的疗效与心脏毒性的临床观察  

CLLNICAL EFFICAY OF MYOCARDIAL ENZYME FOR MONIIORING ANTHRACYCLINE CRDIOTOXICITY IN PATIENTS WITH BREAST CANCER TREATED WITH ANTHRACYCLINE CHEMUTHERAPY

作　　者：石秀换[1] 李云霞[1] 曹冉华[2] 赵春梅[3] 郝喜燕[3] SHI Xiu-huan;LI Yun-xia;CAO Ran-hua(The Affiliated Hospital,Inner Mongolia Medical University,Hohhot 010050 China)

机构地区：[1]内蒙古医科大学附属医院保健中心,内蒙古呼和浩特010050 [2]内蒙古医科大学附属医院肿瘤内科 [3]内蒙古医科大学附属医院核医学科

出　　处：《内蒙古医科大学学报》2018年第6期550-553,共4页Journal of Inner Mongolia Medical University

基　　金：内蒙古自治区卫生厅课题(201301041)

摘　　要：目的:探讨99 mTC-MIBI心肌灌注显像联合心肌酶监测表阿霉素和吡柔比星两种蒽环类药物治疗乳腺癌病人的心脏毒性比较性研究。方法:收集我院2013-12～2017-12收治的原发性乳腺癌病人77例,均行乳腺癌根治术或保乳术,应用CTF方案或CEF方案辅助化疗,A组CTF方案38例、B组CEF方案39例。化疗6个周期,比较分析AB两组的临床疗效及毒性反应。评估化疗前、化疗6周期后心电图、心肌酶、核素心室造影测左室射血分数(LVEF)和99 mTc MIBI心肌灌注断层显像并计算相对定量值。结果:77例均获得6个化疗周期治疗,随访1 a,蒽环类药物治疗6周期后,AB两组病人心肌相对定量值明显下降,但B组的病人心脏毒性明显高于A组(P<0.05),心电图和心肌酶学无明显变化。结论:99 mTC-MIBI心肌灌注断层显像能发现蒽环类药物所致的心肌损害,比心电图和心肌酶学检查更优越,A组CTF辅助化疗方案比B组CEF方案毒性反应更轻。Objective:To investigate the comparative study of 99 mTC-MIBI myocardial perfusion tomography and myocardial enzyme for monitoring anthracycline cardiotoxicity in patients with breast cancer treated with epirubicin and pirarubicin chemotherapy. Methods: We selected 77 breast cancer cases that were accepted treated with breast-conserving surgery and modi ed radical mastectomy.These cases come from The Affiliated Hospital,Inner Mongolia Medical University,which were diagnosed as cancer come from 2013-12~2017-12,77 patients with anthracycline chemotherapy after surgery,and according to different regimens of chemotherapy were divided into 2 groups:CTF(5-fluorouracil+ pirarubicin +cyclophosphamide) for group A of 38 cases,CEF(5-fluorouracil+epirubicin+cyclophosphamide) for group B of 39 cases.After six period chemotherapy, the clinical effects and anthracycline cardiotoxicity of the 2 groups were compared.77 cases were examined by electrocardiogram(ECG),myocardial enzyme(CK-MB),nuclear angiography for detecting left ventricular ejection fraction(LVEF)and 99 mTC-MIBI myocardial perfusion tomography for detecting myocardial relative quantity(MRQ),before and six period chemotherapy. Results: All 77 cases achieved six period chemotherapy,and followed up for 1 year.The MRQ after six period of anthracycline chemotherapy was significantly lower than the pretherapy in 77 patients,and group B significantly higher than group A( P < 0.05 ).There was not significant change in the mean value of ECG and CK-MB. Conclusion: 99 m TC-MIBI myocardial perfusion tomography can monitor the anthracycline cardiotoxicity and its changes are earlier than ECG and CK-MB, The toxicity of group A(CTF)was lighter than that of group B(CEF).

关 键 词：心肌灌注显像 监测 乳腺癌 吡柔比星 表阿霉素 心脏毒性 

分 类 号：R737.9[医药卫生—肿瘤]