盐酸多柔比星化疗的乳腺癌患者心脏毒性的发生和影响因素分析  

Occurrence of cardiotoxicity in breast cancer patients treated with doxorubicin hydrochloride chemotherapy and influence factors

作　　者：王梅 李鹏洲 童隆财 邓政 肖双 唐励静[1,2] 李荣 WANG Mei;LI Peng-zhou;TONG Long-cai;DENG Zheng;XIAO Shuang;TANG Li-jing;LI Rong(Institute of Pharmaceutical Pharmacology,University of South China,Hengyang Hunan 421001;Department of Pharmacy,The Second Affiliated Hospital of University of South China,Hengyang Hunan 421001)

机构地区：[1]南华大学药物药理研究所,湖南衡阳421001 [2]南华大学附属第二医院药学部,湖南衡阳421001

出　　处：《中南药学》2024年第4期1087-1090,共4页Central South Pharmacy

基　　金：湖南省药学会医院药学研究基金项目(No.2020YXH005);湖南省临床医疗技术创新引导项目(No.2021SK51709);湖南省自然科学联合基金项目(No.2022JJ50159)。

摘　　要：目的 调查并分析女性乳腺癌患者应用盐酸多柔比星化疗后,心脏毒性的发生情况和危险因素。方法 选取某市三级甲等医院在2020—2022年接受多柔比星化疗的女性乳腺癌患者临床资料共130份,根据心脏毒性发生情况,分为心脏毒性组(n=28)和无心脏毒性组(n=102),收集患者的一般资料如年龄、肿瘤分期、病理分级、既往疾病史、合并治疗方案、联合用药和放疗等,通过Logistic回归分析揭示导致心脏毒性发生的危险因素。结果 130例接受多柔比星化疗的乳腺癌患者中有28例发生心脏毒性,发生率为21.54%。年龄≥60岁、高血压累计剂量≥160 mg、联合放疗为导致心脏毒性的独立危险因素。结论 年龄、高血压、累计剂量、联合放疗是接受多柔比星化疗乳腺癌患者心脏毒性发生的危险因素,临床用药要密切关注高龄、联合放疗的肿瘤患者,做好心功能指标的监测,同时减少化疗用药剂量或联合使用心脏保护剂右雷佐生来预防或减少心脏毒性的发生。Objective To determine the occurrence of cardiotoxicity and risk factors in female breast cancer patients after application of doxorubicin hydrochloride chemotherapy.Methods Totally 130 clinical data of female breast cancer patients who received doxorubicin chemotherapy from 2020 to 2022 in a tertiary hospital were selected and divided into a cardiotoxicity group(n=28)and a non-cardiotoxicity group(n=102)according to the occurrence of cardiotoxicity.General data of patients such as age,tumor stage,pathological grading,history of previous diseases,combined treatment regimen,combined medication,and radiotherapy,etc.,were collected and the risk factors for the occurrence of cardiotoxicity were determined by Logistic regression analysis.Results Cardiotoxicity occurred in 28(21.54%)of the 130 breast cancer patients receiving doxorubicin chemotherapy.Age≥60 years,history of hypertension,cumulative dose≥160 mg and combination radiotherapy were independent risk factors for cardiotoxicity.Conclusion Age,hypertension,cumulative dose and combined radiotherapy are the risk factors for cardiotoxicity in breast cancer patients receiving doxorubicin chemotherapy.We should pay close attention to the clinical use of drugs in senior patients receiving combined radiotherapy,and monitor cardiac function indexes.Meanwhile,the dosage of chemotherapy should be reduced or combined with cardioprotective agent dexrazoxane to prevent or reduce the occurrence of cardiotoxicity.

关 键 词：盐酸多柔比星 心脏毒性 乳腺癌 危险因素 

分 类 号：R737.9[医药卫生—肿瘤]