TEC方案化疗后乳腺癌患者的早期心脏毒性

目的 观察多西他赛、表柔比星、环磷酰胺(TEC)联合化疗对乳腺癌患者早期心脏毒性影响.方法 收集2009年12月～2011年6月共71例乳腺癌患者,中位年龄48 (35～64)岁,术后予6个周期TEC方案化疗,化疗前及化疗结束时、结束后12h、24 h、48 h及72 h的分别检测血清心肌肌钙蛋白Ⅰ(cTnI)及检查心电图.结果 (1)患者化疗后不同时间点cTnI出现异常的比例均较化疗前明显升高(P＜0.01)； (2)共有8(11.27％)例出现心电图改变,其中窦性心动过速4例(5.63％)、ST-T改变1例(1.41％)、窦性心动过缓2例(2.82％)、房室传导阻滞1例(1.41％),除1例为Ⅱ级毒性反应外,其余7例为Ⅰ级毒性反应.结论 TEC方案化疗后可引起早期心脏毒性反应.

Investigation of early cardiotoxicity in breast cancer patients with TEC chemotherapy regimen

OBJECTIVE To investigate the influence of early cardiotoxicity in patients with breast cancer after TEC chemotherapy regimen.METHODS From December 2009 to June 2011,71 patients with breast cancer,aged from 35-64(medium 48)years were allotted.After surgery,6 cycles of TEC chemotherapy regimen were applied.The changing condition of cTnI was investigated right after the chemotherapy,12 hours later,24 hours later,48 hours later and 72 hours later,and the cardiograph was checked.RESULTS(1)The rate of patients whose cTnI were abnormal rose after the chemotherapy at different time(P﹤0.01).(2)There were 8 cases(11.27%)of cardiograph change,4 cases(5.63%)of sinus tachycardia,one case(1.41%)of ST-T change,2 cases of sinus bradycardia,1 case(1.41%)of atrioventricular block.Except one case of them was level Ⅱ toxic reaction,seven cases of the rest were level I toxic reaction.CONCLUSION The application of TEC chemotherapy regimen could cause early cardiotoxicity.