右丙亚胺对表阿霉素辅助化疗时的心脏保护作用及其机制分析

摘要

Objective:To investigate the cardioprotective role of adjuvant chemotherapy and its mechanism of dexrazoxane(DEX) on epirubicin(EPI).Methods:69 cases of the use of adjuvant chemotherapy for EPI female breast cancer patients were randomly divided into control group(n =34) and observation group(n =35), the observation group were based on EPI on the use of adjuvant chemotherapy DEX,control patients didnt use DEX.They were compared B-type brain natriuretic peptide (BNP), cardiac troponin (cTnT), left ventricular ejection fraction (LVEF), heart rate (HR), systolic blood pressure(SBP), diastolic blood pressure(DBP), ANC count before and after chemotherapy and non-cardiac toxicity,SF-12 scale score of life were compared.Results:In addition to the ANC study group level, other cardiac and hematological function index (BNP, cTnT, LVEF, HR, SBP, DBP) levels were not significantly different(P ＞0.05).Control group after chemotherapy in patients with BNP,cTnT and HR were significandy higher than that before chemotherapy (P ＜ 0.05).After chemotherapy LVEF was significantly lower than that before chemotherapy(P ＜ 0.05).A control group of non-cardiac toxicity rate was 58.82％, the observation group 54.28％,the difference was not statistically significant(P ＞ 0.05).Life according to SF-12 scale score was observed after chemotherapy patients all dimension scores were significantly higher(P ＜ 0.05).After 5 cycles of chemotherapy,half a year and one year after treatment, the abnormal ECG in the control group were significantly higher than those in the observation group (P ＜ 0.05).Conclusion:DEX cardiac breast cancer adjuvant chemotherapy for patients with EPI have better protection,and can effectively improve the quality of life of patients.%目的:探讨右丙亚胺(DEX)对表阿霉素(EPI)辅助化疗时的心脏保护作用及其机制.方法:将69例采用EPI辅助化疗方案的女性乳腺癌患者随机分为对照组(nz=34)与观察组(n=35),观察组患者在EPI辅助化疗的基础上加用DEX,对照组患者未加用DEX.比较两组患者化疗前后B型脑利钠肽(BNP)、心肌肌钙蛋白(cTnT)、左心室射血分数(LVEF)、心率(HR)、收缩压(SBP)、舒张压(DBP)、ANC计数及非心脏毒性反应、SF-12生活量表评分.结果:观察组除ANC水平外,其他心脏及血液学功能指标(BNP、cTnT、LVEF、HR、SBP、DBP)水平差异均无统计学意义(P＞0.05);对照组患者化疗后BNP、cTnT及HR水平均显著高于化疗前(P＜0.05),化疗后LVEF水平显著低于化疗前(P＜0.05).对照组非心脏毒性反应发生率为58.82％,观察组为54.28％,差异无统计学意义(P＞0.05).根据SF-12生活量表评分,观察组患者化疗后各维度评分均显著高于对照组(P＜0.05).白化疗5个周期开始,治疗后半年和1年,对照组心电图异常明显多于观察组(P＜0.05).结论:DEX对行EPI辅助化疗的乳腺癌患者心脏具有较好地保护作用,且可有效改善患者生活质量.