尼可地尔对吡柔比星化疗中心脏毒性的预防作用

PREVENTION EFFECT OF NICORANDIL ON CARDIOTOXICITY CAUSED BY PIRARUBICIN CHEMOTHERAPY

目的探讨在非霍奇金淋巴瘤化疗中,应用尼可地尔预防吡柔比星心脏毒性的临床效果。方法非霍奇金淋巴瘤化疗病人32例,随机分为研究组和对照组,每组16例。两组病人均应用CHOPE方案化疗,研究组加用尼可地尔。于化疗2、4、6个周期后,分别观察两组病人超声心动图、心电图ST段及T波、肌钙蛋白等变化以及非血液性毒性反应。结果随着化疗周期的延长,两组病人的左心室射血分数(LVEF)均下降,在化疗4、6个周期后,对照组病人的LVEF明显低于研究组(t=9.56、11.26,P<0.05)。化疗6个周期后,对照组病人ST段及T波异常发生率、肌钙蛋白异常发生率明显高于研究组(χ2=6.46、6.46,P<0.05)。两组病人均未出现严重的非血液性毒性反应。结论尼可地尔能够预防吡柔比星的心脏毒性,且毒副作用可耐受,有望为临床防治吡柔比星的心脏毒性提供一种新方法。

Objective To investigate the application of Nicorandil in preventing cardiotoxicity caused by Pirarubicin in chemotherapy of non-Hodgkin’s lymphoma. Methods Thirty-two patients receiving chemotherapy for non-Hodgkin’s lymphoma were equally randomized to study group and control group.CHOPE chemotherapy regimen was applied to both groups,and Nicorandil was added to the study group.After two,four and six cycles of the therapy,the changes of echocardiogram,ST segment and T wave of ECG,cardiac troponin and other non-blood toxicity were observed. Results With the extension of chemotherapy cycle,left ventricular ejection fraction（LVEF）in both groups declined,and after four and six cycles of the therapy,the LVEF in the control group was much lower（t=9.56,11.26;P〈0.05）.After six cycles of chemotherapy,the incidence of abnormal ST segment and T wave as well as troponin was higher in the control group than that in the study group（χ2=6.46,P〈0.05）.No non-hematological toxic reactions were observed in both groups. Conclusion Nicorandil,it’s side effects are tolerated,can prevent cardiotoxicity caused by Pirarubicin,and is expected to become a new method for clinical prevention and cure of cardiotoxicity caused by Pirarubicin.