摘要
目的:探讨右丙亚胺(DEX)对表阿霉素(EPI)辅助化疗时的心脏保护作用及其机制。方法:将69例采用EPI辅助化疗方案的女性乳腺癌患者随机分为对照组(n=34)与观察组(n=35),观察组患者在EPI辅助化疗的基础上加用DEX,对照组患者未加用DEX。比较两组患者化疗前后B型脑利钠肽(BNP)、心肌肌钙蛋白(c Tn T)、左心室射血分数(LVEF)、心率(HR)、收缩压(SBP)、舒张压(DBP)、ANC计数及非心脏毒性反应、SF-12生活量表评分。结果:观察组除ANC水平外,其他心脏及血液学功能指标(BNP、c Tn T、LVEF、HR、SBP、DBP)水平差异均无统计学意义(P>0.05);对照组患者化疗后BNP、c Tn T及HR水平均显著高于化疗前(P<0.05),化疗后LVEF水平显著低于化疗前(P<0.05)。对照组非心脏毒性反应发生率为58.82%,观察组为54.28%,差异无统计学意义(P>0.05)。根据SF-12生活量表评分,观察组患者化疗后各维度评分均显著高于对照组(P<0.05)。自化疗5个周期开始,治疗后半年和1年,对照组心电图异常明显多于观察组(P<0.05)。结论:DEX对行EPI辅助化疗的乳腺癌患者心脏具有较好地保护作用,且可有效改善患者生活质量。
Objective:To investigate the eardioproteetive role of adjuvant chemotherapy and its mechanism of dexrazoxane(DEX) on epirubicin(EPI). Methods: 69 cases of the use of adjuvant chemotherapy for EPI female breast cancer patients were randomly divided into control group( n = 34) and observation group( n = 35 ) ,the observa- tion group were based on EPI on the use of adjuvant chemotherapy DEX,control patients didn1 use DEX. They were compared B - type brain natriuretic peptide ( BNP ) , cardiac troponin ( eTnT ) , left ventrieular ejection fraction ( LVEF), heart rate ( HR), systolic blood pressure ( SBP), diastolic blood pressure ( DBP), ANC count before and after chemotherapy and non- cardiac toxicity ,SF- 12 scale score of life were compared. Results:In addition to the ANC study group level, other cardiac and hematological function index( BNP, cTnT, LVEF, HR, SBP, DBP) levels were not significantly different( P 〉 0.05 ). Control group after chemotherapy in patients with BNP,cTnT and HR were signifi- cantly higher than that before chemotherapy ( P 〈 0.05 ). After chemotherapy LVEF was significantly lower than that before chemotherapy(P 〈0.05). A control group of non- cardiac toxicity rate was 58.82% ,the observation group 54.28% ,the difference was not statistically significant( P 〉 0.05 ). Life according to SF -12 scale score was observed after chemotherapy patients all dimension scores were significantly higher( P 〈 0.05 ). After 5 cycles of chemotherapy, half a year and one year after treatment, the abnormal ECG in the control group were significantly higher than those in the observation group ( P 〈 0.05 ). Conclusion : DEX cardiac breast cancer adjuvant chemotherapy for patients with EPI have better protection, and can effectively improve the quality of life of patients.
出处
《现代肿瘤医学》
CAS
2017年第23期3776-3779,共4页
Journal of Modern Oncology
基金
河南省科技发展计划(编号:112102310121)
关键词
乳腺癌
表阿霉素
右丙亚胺
心肌肌钙蛋白
机制
breast cancer, epirubicin, dexrazoxane, cardiac troponin, mechanism