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目的:比较不同治疗方式对乳腺癌患者发生心脏疾病的影响。方法:选择确诊的乳腺癌221例,按照治疗方式分为蒽环类药物化疗组76例、曲妥珠单抗化疗组8例、蒽环类药物+曲妥珠单抗化疗组41例、其他方法化疗组70例和未接受化疗组26例。比较5组乳腺癌患者治疗后1年内心力衰竭和心肌病发病情况,并分析不同年龄段心脏疾病发病情况的差异。结果:曲妥珠单抗组和蒽环类药物+曲妥珠单抗组心脏疾病患病率显著高于蒽环类药物组、其他化疗组及未接受化疗组(P<0.05)。蒽环类药物组随年龄增加心脏疾病发病率逐渐升高(P<0.05),蒽环类药物+曲妥珠单抗组75~80岁年龄段心脏疾病发病率非常显著高于其他年龄段(P<0.01),其他化疗组66~74岁、75~80岁两个年龄段心脏疾病发病率显著高于30~55岁、56~65岁年龄段(P<0.05);蒽环类药物组和蒽环类药物+曲妥珠单抗组在30~55岁年龄段发病率相对较低,但该年龄段治疗后出现心力衰竭或心肌病的例数占各年龄段发病总数的比例却分别高达45.5%和58.3%。结论:单独使用曲妥珠单抗或蒽环类药物联合曲妥珠单抗治疗乳腺癌,可能增加患者心力衰竭和心肌病的发病风险,尤其是年轻患者。
Objective: To compare the different treatment of breast cancer patients with heart disease. Methods: A total of 221 breast cancer patients were selected. According to the treatment methods, they were divided into anthracycline group (76 cases), trastuzumab group (8 cases), anthracycline group (41 cases) and trastuzumab group Methods The chemotherapy group of 70 patients and no chemotherapy group of 26 patients. The incidences of heart failure and cardiomyopathy were compared between the 5 groups of breast cancer patients within one year after treatment, and the differences in the incidence of heart disease at different ages were analyzed. Results: The prevalence of heart disease in trastuzumab group, anthracycline and trastuzumab group was significantly higher than that in anthracycline group, other chemotherapy group and non-chemotherapy group (P <0.05). Anthracycline group increased with age, the incidence of heart disease increased (P <0.05), anthracycline + trastuzumab group 75 to 80-year-old age group the incidence of heart disease was significantly higher than the other age groups ( P <0.01). In other chemotherapy groups, the incidence of heart disease was significantly higher in the two age groups of 66-74 years old and 75-80 years old than in 30-55 years old and 56-65 years old group (P <0.05). Anthracycline group And anthracycline + trastuzumab group in the age group of 30 to 55 years, the incidence is relatively low, but the age group after treatment, heart failure or cardiomyopathy cases accounted for the proportion of the total incidence of each age group were Up to 45.5% and 58.3%. CONCLUSION: Trastuzumab alone or anthracycline plus trastuzumab in breast cancer may increase the risk of developing heart failure and cardiomyopathy, especially in young patients.