阿霉素与表阿霉素的心脏毒性的比较

摘要

Objective To discuss the relaitionship between adriamycin and epirubicin on heart toxicity and drug accumulation .Methods From January 2006 to January 2011 ,the First Affiliated Hospital of Xin‐jiang Medical University had diagnosed 320 cancer patients receiving adriamycin and epirubicin ,the chan‐ges of the levels of electrocardiogram (ECG ) and myocardial enzyme data were tested before and after chemotherapy .Results In 320 cases with adriamycin or epirubicin chemotherapy of tumor patients ,the abnormal rate of ECG was 31 .9% ,the adriamycin accumulation amount of <200 ,200~350 ,350~500 ,>500 mg/m2 the abnormal rate of ECG were 15 .7% ,30 .2% ,47 .7% ,64 .0% ;The epirubicin accumula‐tion amount of <200 ,200~350 ,350~500 ,>500 mg/m2 with the abnormal rate of ECG were 13 .3% , 18 .5% ,32 .1% ,58 .3% .In order to adriamycin and epirubicin as the main auxiliary chemotherapy ECG were compared ,there was no statistical significance ,abnormal rate of breast cancer with TA chemothera‐py before and after the emergence of ECG was 40 .0% ,TE appeared abnormal rate of ECG was 20 .0% , with statistical significance .The abnormal rate of non Hodgkin′s lymphoma by CHOP regimen chemother‐apy before and after the emergence of ECG was 51 .0% ,use the CEOP schemes the abnormal rate of ECG up to 30 .8% (P <0 .05) .Before and after chemotherapy in patients with myocardial enzyme ,there was statistical significance .Conclusion Both adriamycin and epirubicin had cardiac toxicity ,compared with epirubicin ,adriamycin had more cardiac toxicity ;the cardiotoxicity′s size and the amount of drug accumu‐lation had positive correlation .%目的：探讨阿霉素和表阿霉素对心脏的毒性反应及与药物累积量的关系。方法收集2006年1月－2011年1月在新疆医科大学第一附属医院接受阿霉素或表阿霉素化疗的320例肿瘤患者资料，分析患者使用阿霉素或表阿霉素化疗前后的心电图、心肌酶水平的变化。结果320例经阿霉素或表阿霉素化疗后的肿瘤患者，心电图的异常率为31．9％，阿霉素的累积量＜200、200～350、350～500、＞500 mg／m2其心电图的异常率分别为15．7％、30．2％、47．7％、64．0％；表阿霉素的累积量＜200、200～350、350～500、＞500 mg／m2其心电图的异常率分别为13．3％、18．5％、32．1％、58．3％。以阿霉素和表阿霉素为主要辅助化疗为主的心电图比较，差异无统计学意义，乳腺癌采用T A方案化疗前后出现心电图的异常率达40．0％，T E方案出现心电图的异常率达20．0％，差异有统计学意义。非霍奇金淋巴瘤采用CHOP方案化疗前后出现心电图的异常率达51．0％，采用CEOP方案心电图的异常率达30．8％（ P ＜0．05）。化疗前后心肌酶差异有统计学意义。结论阿霉素和表阿霉素均存在心脏毒性且阿霉素的心脏毒性较表霉素大；心脏毒性的大小与药物累积量成正相关。