氨磷汀对乳腺癌化疗患者心脏功能的影响  

Effects of amifostine on cardiac function in patients with breast cancer undergoing chemotherapy

作　　者：董静[1] 祝万洁 司元元 DONG Jing;ZHU Wanjie;SI Yuanyuan(Department of Cardiology,the Second Affiliated Hospital,Zhengzhou University,Zhengzhou 450014)

机构地区：[1]郑州大学第二附属医院心血管内科,郑州450014

出　　处：《郑州大学学报（医学版）》2022年第2期275-279,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省科技发展计划项目(182102310527)。

摘　　要：目的:探讨氨磷汀对乳腺癌化疗患者心电图、左室射血分数(LVEF)和血清B型脑钠肽(BNP)、心肌酶谱的影响。方法:选取88例乳腺癌化疗患者,分为对照组(43例)与试验组(45例)。2组均给予右丙亚胺治疗,试验组加以氨磷汀治疗。检测2组患者治疗前和治疗4周后血清心肌酶谱、BNP、LVEF,观察治疗后心电图变化,观察临床疗效,并统计不良反应。结果:试验组治疗后心电图异常发生率低于对照组(P=0.033)。2组患者治疗后血清肌酸激酶(CK)和肌酸激酶同工酶(CK-MB)水平均高于治疗前,且试验组治疗前后差值小于对照组(P<0.05)。试验组治疗后血清BNP水平低于治疗前,LVEF高于治疗前,且效果优于对照组(P<0.05)。试验组治疗后疾病控制率较对照组提高(P=0.033)。2组治疗期间药物相关不良反应发生率比较,差异无统计学意义(P=0.490)。结论:在乳腺癌化疗患者中,氨磷汀具有阻滞蒽环类药物所致心脏毒性的作用。Aim:To investigate the effects of amifostine on electrocardiogram(ECG),left ventricular ejection fraction(LVEF),B-type brain natriuretic peptide(BNP)and myocardial enzymes in patients with breast cancer.Methods:A total of 88 cases of breast cancer chemotherapy patients were allocated into control group(43 cases)and trial group(45 cases).Both groups were treated with dextropropimine,and the trial group was additionally treated with amifostine.The myocardial enzymes,BNP and LVEF of the 2 groups before and 4 weeks after treatment were detected.The changes of ECG after treatment were observed,the clinical curative effect was observed,and the drug-related toxic and side effects were counted.Results:The incidence of abnormal ECG changes of the trial group was lower than that of the control group(P=0.033).The levels of serum creatine kinase(CK)and creatine kinase isoenzyme(CK-MB)in the 2 groups after treatment were higher than those before treatment,while the changes of serum CK and CK-MB in the trial group were lower than those of the control group after treatment(P<0.05).After treatment,the serum BNP level of the trial group was significantly lower than that before treatment,LVEF was significantly higher than that before treatment,and the effect was better than that of the control group(P<0.05).The disease control rate of the trial group was significantly higher than that of the control group(P=0.033).There was no significant difference in the incidence of drug-related toxic and side effects between the 2 groups during treatment(P=0.490).Conclusion:In patients with breast cancer undergoing chemotherapy,amifostine could block the cardiotoxicity induced by anthracycline.

关 键 词：乳腺癌 化疗 氨磷汀 心电图 心肌酶谱 B型脑钠肽 左室射血分数 

分 类 号：R541[医药卫生—心血管疾病]