黄芪注射液预防多柔比星相关性心脏毒性反应的临床观察

Clinical observation on the prevention of Doxorubicin-associated cardiotoxicity by astragalus injection

目的:探讨黄芪注射液对多柔比星(阿霉素)相关性心脏毒性的保护作用。方法:58例恶性肿瘤患者,随机地分成观察组和对照组两组。观察组30例,在以ADM为主的一线方案化疗前3天予黄芪注射液50ml加入5%葡萄糖注射液250ml中静脉滴注,每日一次,两周一疗程;对照组28例,于化疗前3天开始服用VitE每次100mg,每日两次,辅酶Q10每次20mg,每日三次,两周一疗程。治疗前后检查心电图,超声心动图中左心室舒张末期内径(LVIDD)、左心室收缩末期内径(LVISD)、舒张早期与晚期充盈速度比值(A/E)、射血分数(EF)、短轴缩短率(FS)等各项指标。结果:在本组ADM化疗后,观察组与对照组间,虽然EF差异无显著性(P>0.05),但心电图异常改变及LVIDD、LVISD、A/E、、FS的差异有显著性(P<0.05)。结论:黄芪注射液是预防和减轻ADM引起的急性心脏毒性的较为理想的药物,对慢性心脏毒性发生的减轻也有益。

Purpose:To evaluate the protection of astragalus injection for Doxorubicin (adriamycin)-associated cardiotoxicity. Methods:58 patients were randomized into two groups for this clinical trial. 30 patients were in the test group ,and 28 in control group. Patients in the test group received astragalus injection in 5% glucose solution once every day for two weeks starting three days before adriamycin-based chemotherapy. 28 patients in the control group began to receive oral vitamin E 100 mg twice a day and coenzyme Q10 20 mg three times a day for two weeks. Chemotherapy is the same as that in the test group. Electrocardiogram (ECG) and echocardiogram were employed to evaluate the cardiac function. Results:There was a substantial difference in ejection fracton between the two groups,but the difference was not statistically significant. Statistically significant differences were observed in the two groups with regard to all other parameters,including abnormal changes in ECG and LVIDD、LVISD、A/E、FS. Conclusions:Astragalus injection is a good drug which can prevent the occurrence of acute cardiotoxicity associated with adriamycin. It can also reduce the occurrence of chronic cardiotoxicity.