吡柔比星引起乳腺癌患者心脏毒性反应的相关危险因素分析  

Analysis of related risk factors for cardiotoxicity in breast cancer patients induced by pirarubicin

作　　者：吕琛 杜雪亭 高玲娜 孙红爽 朱小丽 LüChen;DU Xue-ting;GAO Ling-na;SUN Hong-shuang;ZHU Xiao-li(Department of Medical Oncology,the People’s Hospital of Hengshui,Department of Pharmacy,the People’s Hospital of Hengshui,Hengshui HEBEI 053000,China)

机构地区：[1]衡水市人民医院肿瘤内科,河北衡水053000 [2]衡水市人民医院药学部,河北衡水053000

出　　处：《中国新药与临床杂志》2021年第8期588-591,共4页Chinese Journal of New Drugs and Clinical Remedies

基　　金：2021年度河北省医学科学研究课题计划(202111945)。

摘　　要：目的对吡柔比星引起乳腺癌患者心脏毒性反应的相关危险因素进行分析。方法收集以吡柔比星为基础化疗的乳腺癌住院患者280例,回顾性分析心脏毒性反应发生情况;同时分析患者的年龄、体重指数、疾病分期等一般资料及联合治疗等对心脏毒性反应发生率的影响。通过多因素logistic回归法分析吡柔比星治疗后患者出现心脏毒性反应的危险因素。结果 280例患者中吡柔比星引起心脏毒性反应发生例数为76例(27.1%)。与无毒性反应患者相比,发生心脏毒性反应患者合并高血压、糖尿病、高脂血症的比例高(P <0.05)。联合曲妥珠单抗治疗患者的心脏毒性反应发生率显著高于未使用者(P=0.003),化疗联合放疗患者心脏毒性反应发生率显著高于未放疗者(P <0.001)。多因素logistic回归分析显示合并高脂血症(OR=3.217,95%CI:1.767~5.860,P=0)和联用曲妥珠单抗(OR=2.571,95%CI:1.299~5.087,P=0.007)对心脏毒性反应的发生有显著影响。结论以吡柔比星为基础化疗的乳腺癌患者心脏毒性反应发生率较高。合并高脂血症和联合曲妥珠单抗治疗是心脏毒性反应发生的独立危险因素。AIM To analyze the risk factors of cardiotoxicity in breast cancer patients induced by pirarubicin. METHODS A total of 280 breast cancer patients with pirarubicin-based chemotherapy were collected, and the incidence of cardiotoxicity were analyzed retrospectively. At the same time, the influence of age, body mass index, the stage of disease and the effect of combined treatment on incidence rate of cardiotoxicity were analyzed. The risk factors of cardiotoxicity treated with pirarubicin were analyzed by multivariate logistic regression method. RESULTS Among the 280 patients, the number of pirarubicin-induced cardiotoxicity was 76(27.1%). Compared with patients without cardiotoxicity, patients with cardiotoxicity had a high proportion of patients with hypertension, diabetes and hyperlipidemia(P < 0.05). The incidence of cardiotoxicity in patients treated with trastuzumab was significantly higher than that of non-users(P = 0.003). The incidence of cardiotoxicity in patients with chemotherapy combined with radiotherapy was significantly higher than that of non-radiotherapy patients(P < 0.001). Multivariate logistic regression analysis showed that combined hyperlipidemia(OR = 3.217, 95%CI: 1.767 ~ 5.860, P = 0) and combined use of trastuzumab(OR = 2.571, 95%CI: 1.299 ~ 5.087, P = 0.007) had a significant impact on the occurrence of cardiotoxicity. CONCLUSION The incidence of cardiotoxicity is higher in breast cancer patients treated with pirarubicin-based chemotherapy. Combined hyperlipidemia and trastuzumab therapy are independent risk factors for cardiotoxicity.

关 键 词：吡柔比星 乳腺肿瘤 心脏毒性 危险因素 

分 类 号：R737.9[医药卫生—肿瘤]