蒽环类药物及蒽环序贯紫杉类方案对乳腺癌辅助化疗后心脏毒性的影响

目的 研究蒽环类药物及蒽环序贯紫杉类两种化疗方案,对乳腺癌辅助化疗后引起的心脏毒性影响.方法 乳腺癌辅助化疗患者84例,根据化疗方案的不同,将其分为蒽环类组42例和蒽环序贯紫杉类组42例.蒽环类组患者接受蒽环类药物化疗方案治疗,而蒽环序贯紫杉类组则接受蒽环序贯紫杉类化疗方案治疗.试验过程中,分别于化疗前、首次化疗后及末次化疗次日3个实验时间点上,测定所有研究对象的静脉肌钙蛋白T和肌红蛋白含量,同时借助自制心脏毒性评级表评价患者心脏毒性级别,以评估上述两种化疗方案对患者引起的心脏毒性程度.结果 两种化疗方案组患者在进行辅助化疗后,静脉肌钙蛋白T含量均没有超出正常范围(P<0.1 ng/ml);在末次治疗后,蒽环序贯紫杉类组静脉肌钙蛋白T含量为(0.0210±0.0166)ng/ml,而另外一组为(0.0390±0.0168)ng/ml,前者低于后者,但无统计学意义(P>0.05);两组患者在3个实验时间点上的肌红蛋白含量均未发生明显变化,且均低于21 ng/ml;两组患者末次化疗后心脏毒性评级表情况,未出现明显差异.结论 蒽环序贯紫杉类化疗方案较蒽环类药物化疗方案,并没有引起患者心脏毒性的明显增大;静脉肌钙蛋白T含量及肌红蛋白含量在评估患者心脏毒性程度方面发挥一定的作用,但尚存在进一步优化之处.

The Effect of Anthracycline and Anthracycline Sequential Taxanes on Cardiac Toxicity in Patient with Breast Cancer after Adjuvant Chemotherapy

Objective To study the effect of anthracycline and anthracycline sequential taxane chemotherapy on cardiac toxicity in breast cancer after adjuvant chemotherapy. Methods 84 patients with breast cancer were treated with adjuvant chemo-therapy. According to the chemotherapy regimen,42 patients were anthracycline group and 42 patients were anthracycline and se-quential taxane group. The anthracycline group received anthracycline chemotherapy, while the anthracycline sequential taxane group received anthracycline sequential taxane chemotherapy. During the test, respectively, before chemotherapy, after the first chemotherapy and the next day of last chemotherapy,venous troponin T and myoglobin content of all research objects were detec-ted,at the same time with the self rating scale to evaluate cardiac toxicity in patients with heart toxicity level,to assess the extent of the cardiac toxicity of 2 chemotherapy regimens for patients. Results After chemotherapy,intravenous troponin T levels did not exceed the normal range (P<0. 1 ng/ml);after last treatment,anthracycline taxane group sequential venous troponin T content was (0. 0210+0. 0166) ng/ml,and the other group was (0. 0390 +0. 0168) ng/ml,the former was lower than the latter,but without statistical significance (P>0. 05);myoglobin content at the 3 experimental time points of the 2 groups of patients were not significantly changed,and were all lower than 21 ng/ml;the 2 groups of patients after the last chemotherapy cardiac toxicity rating scale had no obvious difference. Conclusion Sequential anthracycline taxane chemotherapy compared with anthracycline chemotherapy has not caused obvious increase in cardiac toxicity;the content of troponin T and myoglobin content vein play a cer-tain role in the assessment of patients with cardiac toxicity,but there still need further optimization.