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化疗联合靶向治疗对乳腺癌患者心脏毒性的研究

A Study of the Cardiotoxicity of Combination with Chemotherapy and Targeted Therapy for Breast Cancer
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摘要 目的评估Her2阳性乳腺癌术后辅助化疗联合靶向治疗的心脏毒性。方法将研究对象分为化疗组51例、化疗联合单靶组62例和化疗联合双靶组47例,分析治疗前、治疗后第3、6、9、12、24月时间点的心率、左心室射血分数(LVEF)和肌酸激酶同工酶(CK-MB)水平及心脏毒性。结果与治疗前相比,化疗组治疗后第3、6、9月时间点LVEF水平下降(均P<0.05);同样的差异在化疗联合单靶组和联合双靶组第3、6、9、12月时间点也存在(均P<0.01);组间比较,与单纯化疗组相比,治疗后第3、6月时间点化疗联合单靶组和联合双靶组的LVEF水平均降低(均P<0.01);心率和CK-MB水平尚无统计学差异。心脏毒性在化疗组5例,化疗联合单靶组20例,化疗联合双靶组14例,组间比较有统计学差异(P<0.05),化疗联合单靶组与联合双靶组组间比较差异无统计学意义(P>0.05)。结论心脏毒性在化疗联合单靶组和联合双靶组之间无差异,且绝大多数是可以恢复的,LVEF可作为靶向治疗心脏毒性的有效评估手段。 Objective To evaluate the cardiotoxicity of chemotherapy combined with targeted therapy for HER2 positive breast cancer.Metholds Patients were devided into:chemotherapy group(C group;51 cases),chemotherapy plus trastuzumab group(C+H group;62 cases)and chemotherapy plus trastuzumab and pertuzumab group(C+H+P group;47 cases).The changes of heart rate,left ventricular ejection fraction(LVEF)and creatine kinase-MB(CK-MB)at baseline,3,6,9,12 and 24 month after treatment were analyzed,and the Incidence rate of cardiotoxicity was also calculated.Results The LVEF level in C group significantly decreased at 3 month,6 mouth and 9 mouth(all P<0.05),the same significant differences were also detected in C+H group and C+H+P group at 3 month,6 month,9 month and 12 month(all P<0.01).The comparison in groups:For C group,the LVEF level of C+H group and C+H+P group at 3 month and 6 month significantly decreased(all P<0.01);there were no significant differences in heart rate and CK-MB.The cardiotoxicity was found in 5 patients of C group,20 patients of C+H group and 14 patients of C+H+P group,and there was statistical difference between groups(P<0.05),and there was no statistical difference between C+H group and C+H+P group(P>0.05).Conclusion Differences of cardiotoxicity between chemotherapy combined with single or double targeted therapy were not detected,and most of them can recoverable.The LVEF level may be used as an effective method to predict cardiotoxicity of targeted therapy.
作者 黄玉 石印青 武英材 陈斐 HUANG Yu;SHI Yinqing;WU Yingcai;CHEN Fei(Medical School,Shanxi Datong University,Datong Shanxi,037009;Department of General Surgery,The third people’s hospital of datong,Datong Shanxi,037000)
出处 《山西大同大学学报(自然科学版)》 2024年第5期80-84,共5页 Journal of Shanxi Datong University(Natural Science Edition)
基金 山西大同大学2020年度青年科研基金项目[2020Q9]。
关键词 HER2阳性乳腺癌 曲妥珠单抗 帕妥珠单抗 心脏毒性 Her2 positive breast cancer trastuzumab pertuzumab cardiotoxicity
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