右丙亚胺对于表阿霉素心脏毒性的保护作用

目的:观察右丙亚胺（dexrazoxane,DEX）对表阿霉素（EPI）辅助化疗时的心脏保护作用。方法:随机将来我院治疗的女性乳腺癌患者分为观察组和对照组，两组患者均采用EPI为主的术后辅助化疗方案，观察组在EPI为主的化疗方案基础上加用DEX（DEX∶EPI＝10∶1），在第1次应用EPI时即给予DEX。采用心肌钙蛋白T（cTnt)和左心室射血分数（LVEF）监测治疗前、治疗第1和第3个周期、治疗完成时、完成后半年、1年的心脏功能状态，同时观察治疗的非心脏毒性。结果:两组患者在年龄、体重、ECOG评分和分期方面没有统计学差异（P>0.05）。EPI治疗第1个周期开始cTnt明显上升，到治疗结束时达到最高，直到治疗后1年仍然维持在较高水平；加用DEX组在治疗期间及治疗后cTnt水平都较低；而LVEF在两组的各个治疗阶段水平都没有统计学差异（P>0.05）；两组的非心脏不良反应没有差异。结论:EPI从第1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。

The protection of dexrazoxane to epirubicin on the cardiotoxicity

Objective：To observe the heart protective effect of dexrazoxane（DEX）on epirubicin（EPI） adjuvant chemotherapy. Methods：Women with breast cancer treated in our hospital were divided into observation group and control group,and all patients were treated with EPI - based adjuvant chemotherapy. The observation group EPI - based chemotherapy used DEX（ DEX： EPI = 10：1 ） at the 1st EPI application when giving the DEX. The cardiac tro- ponin T（cTnt） and left ventricular ejection fraction（LVEF） were used to monitor cardiac functional status before treatment, paragraphs 1 and 3 cycles. Results： Two groups in age, weight, ECOG score and staging were no statistically significant difference（P 〉 0.05）. The cTnt was significantly increased in one cycle of treatment,and at the end of the treatment was highest until 1 year after treatment remained at a high level. The cTnt level of the group with DEX dur- ing the treatment and after treatment were lower, the LVEF in the two the various stages of treatment group were not statistically significant level（P 〉 0.05 ）. The non - cardiac side effects were no differences in both groups. Conclu- sion：EPI to the heart produced significant toxicity, and DEX can reduce this cardiotoxicity.