西红花总苷片结合微量泵输注多柔比星防治弥漫性大B细胞淋巴瘤患者急性心脏损伤的临床疗效  

Clinical Observation on Crocin Tablets Combined with Micropump Infusion of Doxorubicin for Prevention of Acute Cardiotoxicity in Patients with Diffuse Large B-cell Lymphoma

作　　者：董克臣 梁毅[1] 李松 曹曼 刘丹[1] 费新雄 DONG Kechen;LIANG Yi;LI Song;CAO Man;LIU Dan;FEI Xinxiong(Huangshi Central Hospital/Affiliated Hospital of Hubei Polytechnic University,Huangshi 435200,China;Hubei Key Laboratory of Kidney Disease Pathogenesis and Intervention,Huangshi 435200,China)

机构地区：[1]黄石市中心医院/湖北理工学院附属医院,湖北黄石435200 [2]肾脏疾病发生与干预湖北省重点实验室,湖北黄石435200

出　　处：《中国实验方剂学杂志》2024年第17期131-137,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：湖北省自然科学基金项目(2022CFB498);黄石市社会科学研究课题(2023sk207)。

摘　　要：目的:观察西红花总苷片结合微量泵输注多柔比星防治弥漫性大B细胞淋巴瘤(DLBCL)患者急性心脏损伤的临床效果,并探讨相关机制。方法:选择2022年10月至2023年10月从黄石市中心医院收集的DLBCL患者病例,将符合纳入标准的92例受试者按照1∶1比例随机分配至对照组和观察组,每组各46例。对照组行常规静脉输注多柔比星,观察组接受西红花总苷片联合微量泵输注多柔比星。比较两组异常心电图发生情况、化疗前后心肌损伤标志物、心功能指标、氧化应激、炎性因子和血液流变学指标变化。结果:观察组异常心电图发生率(23.91%,11/46)显著低于对照组(54.35%,25/46),差异有统计学意义(χ^(2)=8.944,P<0.01)。化疗后第8天,观察组肌酸激酶同工酶(CK-MB)和心肌肌钙蛋白(I cTnI)异常率明显低于对照组,差异有统计学意义(χ^(2)=4.423、4.857,均P<0.05)。与对照组治疗后比较,观察组N末端B型脑钠肽前体(NT-proBNP)水平显著下降,左室射血分数(LVEF)显著升高(P<0.01);观察组总抗氧化能力(T-AOC)和超氧化物歧化酶(SOD)水平显著升高(P<0.01),观察组白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平显著下降,差异有统计学意义(P<0.01);观察组全血低切黏度(LWBV)、全血高切黏度(HWBV)、血浆黏度(PV)和纤维蛋白原(FIB)水平均显著下降(P<0.01)。结论:西红花总苷片结合微量泵输注多柔比星能够有效减轻DLBCL患者急性心脏损伤,降低异常心电图发生率,具有保护心肌细胞和改善心功能作用。其机制可能与抗氧化、抗炎及改善血液流学等相关。Objective:To observe the clinical effect of crocin tablets(CRO)combined with micropump infusion of doxorubicin in the prevention of acute cardiotoxicity in the patients with diffuse large B-cell lymphoma(DLBCL)and explore the related mechanism.Method:The patients with DLBCL treated in the Huangshi Central Hospital from October 2022 to October 2023 were selected,and 92 patients who met the inclusion criteria were randomly assigned to a control group and an observation group at a ratio of 1∶1,with 46 patients in each group.The control group underwent conventional intravenous infusion of doxorubicin,and the observation group received CRO combined with micropump infusion of doxorubicin.The changes of abnormal ECG,myocardial injury markers,cardiac function indicators,oxidative stress,inflammatory mediators,and hemorheological indexes before and after chemotherapy were compared between the two groups.Result:The incidence of abnormal ECG in the observation group was 23.91%(11/46),which was lower than that(54.35%,25/46)in the control group(χ^(2)=8.944,P<0.01).On day 8 after chemotherapy,the abnormal rates of creatine kinase-MB(CK-MB)and cardiac troponin I(cTnI)in the observation group were lower than those in the control group(χ^(2)=4.423,4.857,both P<0.05).Compared with the control group after chemotherapy,the observation group showed lowered level of N-terminal pro-B-type natriuretic peptide,elevated left ventricular ejection fraction and levels of total antioxidant capacity and superoxide dismutase(P<0.01),declined levels of interleukin-6 and tumor necrosis factor-α(P<0.01),and decreased low whole blood viscosity,high whole blood viscosity,plasma viscosity,and fibrinogen(P<0.01).Conclusion:CRO combined with micropump infusion of doxorubicin can mitigate acute cardiotoxicity,reduce the incidence of abnormal ECG,protect cardiomyocytes,and improve the cardiac function by exerting the antioxidant and antiinflammatory effects and improving blood flow.

关 键 词：弥漫性大B细胞淋巴瘤 多柔比星 心脏毒性 西红花总苷片 疗效 机制 

分 类 号：R856.2[医药卫生—航空、航天与航海医学] R969.4[医药卫生—临床医学] R242R979.1R730.5