中药注射剂对蒽环类药物所致心脏毒性的保护作用

目的评价中药注射剂对蒽环类药物所致心脏毒性的保护作用。方法 120例肿瘤患者被随机分为A、B、C、D四组,每组30例。所有患者均采用含蒽环类药物的化疗方案进行治疗,A组、B组、C组、D组的患者分别在化疗的基础上加用黄芪注射液、参麦注射液、右丙亚胺及中药注射剂联合右丙亚胺,共治疗4个周期(28天一个周期)。观察治疗前后各组患者的心电图变化、左心室射血分数及心肌肌钙蛋白的定性检测。结果治疗后,D组异常心电图患者的比例显著低于A、B、C三组(P分别为0.02,0.04,0.04),但是A、B、C三组之间两两比较差异无统计学意义(P分别为0.77,0.77,1.00);A、B、C三组患者的左心室射血分数显著低于治疗前(P=0.00),D组患者的左心室射血分数与治疗前比较差异无统计学意义(P=0.06),但是显著高于A、B、C三组(P=0.00);A、B、C、D四组间异常心肌肌钙蛋白患者的比例比较差异无统计学意义(P=0.63)。结论黄芪注射液和参麦注射液对蒽环类药物所致心脏毒性有一定的保护作用,其疗效与右丙亚胺相当,且与右丙亚胺具有协同作用。

Protective Effects of Traditional Chinese Medicine Injections against Anthracycline-Induced Cardiac

Objective To evaluate the protective effects of traditional Chinese medicine injection against anthracycline-induced cardiac toxicity. Methods All 120 malignant tumor patients were randomly classified into group A, B, C, D （30 patients in each group）. All the patients were treated with the chemotherapy regimens including anthracyclines. Patients in group A, B, C, and D were respectively given HuangQi injection, ShenMai injection, dexrazoxane, traditional Chinese medicine injection combined with dexrazoxane for four chemotherapy cycles based on the original chemotherapy regimens, 28 days was set a cycle. The changes of electro-cardiogram （ECG）, left ventricular ejection fraction （LVEF） and qualitative detection of cardiac troponin I （cTnI） were observed before and after treatment. Results The percentage of patients with abnormal ECG in group D was sig-nificantly lower than that in group A, B, C after treatment （P=0.02, 0.04, 0.04, respectively）, but there were no significant differ-ences between group A, B, C （P=0.77,0.77, 1.00, respectively）. The LVEF was decreased markedly after treatment in group A, B, C （P=0.00） after treatment and there was no significant difference before and after treatment in group D （P=0.06） and it was significantly higher than that in group A, B, C （P=0.00） . No significant differences in the percentage of patients with abnormal cTnI were observed between group A, B, C, D （P=1.00, 0.55, 0.55, 0.55, 0.55, 1.00, respectively）. Conclusion HuangQi and ShenMai injection had certain protective effects against the cardiac toxicity induced by anthracyclines. They had equivalent effects to dexrazoxane and it could assist dexrazoxane to against the cardiac toxicity of anthracyclines.