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[目的]观察右丙亚胺(DEX)对高复发风险早中期女性乳腺癌患者术后辅助化疗时的心脏保护作用。[方法]将患者随机分为治疗组和对照组,两组患者均采用EPI+DTX为主的术后辅助化疗方案,治疗组同时加用DEX(DEX∶EPI=10∶1),应用心肌肌钙蛋白T(cTnt)和左心室射血分数(LVEF)监测治疗前、第1周期、第3周期、治疗完成时、完成后半年、1年和2年的心脏功能状态,同时观察治疗的非心脏毒性。[结果]治疗组从第一周期开始cTnt明显上升,到治疗结束时达到最高,直到治疗后2年仍然维持在较高水平,而加用DEX组在治疗期间及治疗后水平都较低,两组LVEF在治疗各阶段无统计学差异,两组的非心脏副反应没有差异。[结论]EPI从第一次应用时对心脏就产生了明显的毒性,加用DEX可以降低这种心脏毒性,DEX+EPI+DTX方案适合具有高复发风险的女性乳腺癌的术后辅助化疗。
[Objective] To observe the cardioprotective effect of dexrazoxane (DEX) on postoperative adjuvant chemotherapy in breast cancer patients with high risk of relapse. [Methods] The patients were randomly divided into treatment group and control group. EPI + DTX-based postoperative adjuvant chemotherapy was used in both groups. DEX (DEX: EPI = 10: 1) Cardiac troponin T (cTnt) and left ventricular ejection fraction (LVEF) were monitored before treatment, the first cycle, the third cycle, the completion of treatment, the completion of six months, one year and two years of cardiac function, while observing the treatment of non Cardiac toxicity. [Results] In the treatment group, the cTnt increased significantly from the first cycle to the highest level at the end of the treatment and remained high at 2 years after treatment. However, the levels of cTnt in the treatment group during treatment and after treatment were both low, There was no significant difference in the LVEF group between the two treatment stages. There was no difference in non-cardiac side effects between the two groups. [Conclusion] EPI has obvious toxicity to the heart from the first application. Adding DEX can reduce the cardiotoxicity. The DEX + EPI + DTX regimen is suitable for postoperative adjuvant chemotherapy for women with high risk of recurrent breast cancer.