蒽环类药物致乳腺癌患者急性心脏毒性的发生及影响因素的回顾性研究

An Analysis of Incidence and Risk Factor of Acute Cardiactoxicity Associated with Anthracyclines Use in Patients with Breast Cancer

目的研究蒽环类药物致乳腺癌患者急性心脏毒性情况并对相关影响因素进行分析,为合理用药提供参考。方法对《蒽环类药物心脏毒性防治指南(2013年版)》正式实施前在我院接受化疗的213例乳腺癌患者进行描述性分析和Logistics回归分析。结果根据心电图的改变预测急性心脏毒性的发生:蒽环类药物致37%的乳腺癌住院患者心电图发生改变,即发生了急性心脏毒性。结论在所有的相关影响因素中,有既往治疗、相对高龄、绝经后是导致患者急性心脏毒性的主要因素。对于此类乳腺癌患者,临床药师应给予更多的药学监护,同时应合理使用保护心脏的药物。建议蒽环类药物应做到个体化精准用药。

OBJECTIVE To assess the risk of acute cardiactoxicity associated with anthracyclines use in patients with breast cancer and investigate the influencing factors on acute cardiactoxicity. METHODS Cross-sectional analysis was carried out for 213 inpatients with breast cancer who received chemotherapy. RESULTS ECG changes occurred in 37% patients. It was estimated that the incidence of acute cardiactoxicity associated with anthracyclines was about 30%. The main risk factors of acute eardiactoxicity were previous chemo- therapy or radiotherapy, relative higher age≥〉55） , and menopause. CONCLUSION ECG is an effective examination method for the patients who have acute cardiactoxicity reactions associated with anthracyelines. Clinical pharmacists should give more pharmaceutical care to post-menopause patients who have previously received chemotherapy or radiotherapy and are relatively old（ ≥55 years）.