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目的探讨右丙亚胺对乳腺癌患者术后行吡柔比星化疗导致心脏毒性的保护作用。方法选取2012年1月至2015年12月间在北京市石景山医院接受乳腺癌根治术及术后吡柔比星化疗的156例患者。采用随机数表法将患者分成观察组和对照组,每组78例,观察组患者术后采用在吡柔比星、环磷酰胺和紫杉醇化疗方案(AC-T化疗)基础上给予右丙亚胺治疗,对照组患者术后采用AC-T化疗方案,随访12个月,对比两组患者治疗前后左室射血分数(LVEF)、超敏肌钙蛋白T(hs-cTnT)及脑钠肽(BNP)水平,记录两组患者心电图改变以及治疗后的不良反应。结果观察组患者治疗前后的LVEF、hs-cTnT及BNP水平比较,差异无统计学意义(P>0.05),治疗3个月、6个月及12个月后,观察组患者的LVEF水平均明显高于对照组患者,差异有统计学意义(P<0.05),观察组患者治疗12个月后hs-cTnT及BNP水平均明显低于对照组患者,差异有统计学意义(P<0.05)。观察组患者治疗后的心电图改变总异常率是11.5%,明显低于对照组患者的24.4%,差异有统计学意义(P<0.05)。观察组患者治疗后的不良反应总发生率是10.3%,明显低于对照组患者的25.6%,差异有统计学意义(P<0.05)。结论右丙亚胺对乳腺癌患者术后使用吡柔比星化疗导致的心脏毒性有较好的保护作用,且用药安全性较高,值得临床推广。
Objective To investigate the protective effect of dexrazoxane on cardiotoxicity induced by prazrubin in patients with breast cancer after operation. Methods 156 patients who underwent radical mastectomy and postoperative pirarubicin chemotherapy at Shijingshan Hospital in Beijing from January 2012 to December 2015 were selected. Patients were divided into observation group and control group using random number table method, 78 cases in each group. Patients in observation group were treated with pirarubicin, cyclophosphamide and paclitaxel chemotherapy (AC-T chemotherapy) The patients in the control group were treated with AC-T chemotherapy. The patients were followed up for 12 months. The changes of left ventricular ejection fraction (LVEF), hs-cTnT and brain natriuretic peptide (BNP) levels were recorded ECG changes in both groups of patients and treatment of adverse reactions. Results There was no significant difference in the levels of LVEF, hs-cTnT and BNP before and after treatment between the observation group and the observation group (P> 0.05). After 3 months, 6 months and 12 months of treatment, the LVEF levels of the observation group were significantly (P <0.05). The levels of hs-cTnT and BNP in the observation group were significantly lower than those in the control group after 12 months of treatment (P <0.05), and the difference was statistically significant (P <0.05). The total abnormal rate of electrocardiogram changes after treatment in the observation group was 11.5%, which was significantly lower than that in the control group (24.4%, P <0.05). The total incidence of adverse reactions in the observation group after treatment was 10.3%, which was significantly lower than that in the control group (25.6%, P <0.05). Conclusion: Propylamine has a good protective effect on the cardiotoxicity induced by pirarubicin in patients with breast cancer after operation, and the drug is safe and worthy of clinical application.