右丙亚胺对合并2型糖尿病胃癌患者表柔比星化疗的心肌保护作用

Cardioprotective effect of dexrazoxane in patients with type 2 diabetes accompanying gastric cancer treated with epirubicin chemotherapy

目的:观察右丙亚胺对接受表柔比星化疗的合并2型糖尿病胃癌患者的心肌保护作用。方法:选择合并2型糖尿病的胃癌患者80例,随机分为右丙亚胺组与对照组,每组各40例。对照组采用表柔比星联合化疗方案治疗,右丙亚胺组在对照组用药方案基础上给予右丙亚胺。比较两组治疗前后不同时段的血清肌钙蛋白I和B型脑钠肽水平,以及两组心电图异常发生率。结果:治疗前两组的肌钙蛋白I和B型脑钠肽水平无明显差异(P>0.05),治疗后以及随诊期间右丙亚胺组肌钙蛋白I和B型脑钠肽含量均明显低于对照组(P<0.05);右丙亚胺组治疗后的心电图异常率为27.50%(11/40),明显低于对照组[52.50%(21/40),P<0.05];随诊3个月,右丙亚胺组的心电图异常率为25.00%(10/40),低于对照组的40.00%(16/40),但差异无统计学意义(P>0.05);随诊6个月,右丙亚胺组的心电图异常率为17.50%(7/40),明显低于对照组[37.50%(15/40),P<0.05]。结论:右丙亚胺对接受表柔比星化疗的合并2型糖尿病胃癌患者的心脏具有有效的保护功能,并可以对已经形成的心脏损害发挥一定的治疗作用,使表柔比星的临床应用更具有效性以及安全性。

Objective: To investigate the myocardium protective effect of dexrazoxane in patients with type 2 diabetes accompanying gastric cancer treated with epirubicin chemotherapy. Methods: Eighty cases of patients with type 2 diabetes accompanying gastric cancer were treated and divided into two groups randomly. The control group was treated with epirubicin combination chemotherapy,the observation group was treated with epirubicin combination chemotherapy and dexrazoxane. The levels of troponin I and B type natriuretic peptide in two groups before and after treatment were compared,and the incidence of abnormal ECG in the two groups was compared. Results: There was no significant difference in the levels of troponin I and B type natriuretic peptide in the two groups before treatment( P > 0. 05); after treatment and follow-up period,the troponin I and B type natriuretic peptide in the observation group were significantly lower than those in the control group( P < 0. 05); after treatment,the abnormal rate of ECG in the observation group was 27. 50%( 11/40),which was significantly lower than that in the control group52. 50%( 21/40)( P < 0. 05); by following up for 6 months,the abnormal rate of ECG in the observa-tion group was 17. 50%( 7/40),which was significantly lower than 37. 50%( 15/40) of the control group( P < 0. 05). Conclusion: Dexrazoxane was shown to have effective cardiac protective function in patients with type 2 diabetes accompanying gastric cancer treated with epirubicin chemotherapy,it can also treat the existing heart damage,so that the clinical application of epirubicin is promising.