表柔比星化疗的乳腺癌患者心脏毒性的发生及影响因素的研究  

Study on the occurrence and influencing factors of cardiotoxicity in breast cancer patients treated with epirubicin

作　　者：吴玉婷[1,4] 陈颖 朱小丽[3] 朱卫忠[4] WU Yu-ting;CHEN Ying;ZHU Xiao-li;ZHU Wei-zhong(Taizhou People's Hospital,Taizhou 225300,China;School of Public Health,Nantong University,Nantong 226019,China;Harrison International Peace Hospital,Hengshui 053000,China;School of Pharmacy,Nantong University,Nantong 226001,China)

机构地区：[1]泰州市人民医院,江苏泰州225300 [2]南通大学公共卫生学院,江苏南通226019 [3]哈励逊国际和平医院,河北衡水053000 [4]南通大学药学院,江苏南通226001

出　　处：《中国药物应用与监测》2020年第5期292-294,309,共4页Chinese Journal of Drug Application and Monitoring

基　　金：国家自然科学基金项目(81770400)。

摘　　要：目的:探讨乳腺癌患者在接受表柔比星化疗后心脏毒性的发生情况及其相关危险因素分析。方法:采用回顾性研究的方法,收集276例接受表柔比星化疗的乳腺癌患者信息资料,根据其心脏毒性发生情况,分为无心脏毒性组和心脏毒性组,采用Logistic回归分析两组年龄、体重指数、肿瘤分期、既往疾病史、联合放疗、联合化疗药物等因素,揭示发生心脏毒性的危险因素。结果:276例接受表柔比星化疗的乳腺癌患者中,110例发生心脏毒性,发生率为39.86%。高血压病史、高血脂病史、联合放疗、联合曲妥珠单抗、未联合使用右丙亚胺为导致心脏毒性的独立危险因素。结论:乳腺癌患者在接受表柔比星化疗后心脏毒性发生率较高,对于既往有高血压病史、高血脂病史、联合放疗、联合曲妥珠单抗治疗的患者应该加强监护,积极控制患者血压及血脂水平,同时联合使用右丙亚胺,避免心脏毒性的发生。Objective:Explore the cardiotoxicity induced by epirubicin and its relevant risk factors in patients with breast cancer.Methods:276 breast cancer patients receiving epirubicin chemotherapy were retrospectively collected and divided into cardiotoxicity group and non-cardiotoxicity group.Data of enrolled patients in the two groups were analyzed in terms of age,body mass index(BMI),tumor stage,previous disease history,combination of radiotherapy and other chemotherapy drugs,etc by logistic regression in order to explore the risk factors of cardiotoxicity induced by epirubicin.Results:110 of 276 patients developed cardiotoxicity and the incidence of cardiotoxicity induced by epirubicin was 39.86%.The independent risk factors of cardiotoxicity induced by epirubicin included medical history of hypertension,hyperlipidemia,combination of radiotherapy and trastuzumab,and non-combination of dexrazoxane.Conclusion:The incidence of cardiotoxicity induced by epirubicin in breast cancer patients was relatively high.During the treatment of epirubicin for breast cancer patients with hypertension,hyperlipidemia,radiotherapy and trastuzumab,dexrazoxane,more pharmaceutical care should be given to them to control the level of blood pressure and blood lipid in order to avoid cardiotoxicity induced by epirubicin.

关 键 词：表柔比星 心脏毒性 乳腺癌 危险因素分析 

分 类 号：R969.4[医药卫生—药理学] R979.1[医药卫生—药学]