护心药物及分次给药对阿霉素心脏毒性的影响

目的观察阿霉素的心脏毒性并探讨减轻心脏毒性的方法.方法恶性实体肿瘤患者共243名,治疗前ECG正常,以阿霉素为主的联合化疗的方案治疗.243名患者分为二组治疗组168例给予辅酶Q10、维生素E保护心肌,其中A组96例用阿霉素1次性给药,B组72例阿霉素分2次给药;对照组75例1次性给药且不给予护心药物.以化疗后出现ECG异常归为心脏毒性.结果A组出现ECG异常23例(23.71%),对照组ECG异常27例(36.00%),二组比较有明显差异(P＜0.05);B组ECG异常13例(18.05%),A组与B组比较,ECG异常明显增高.结论给予维生素E和辅酶Q10及分次给药能减轻阿霉素所致的心脏毒性.

Clinical Evaluation of the Drug of Protecting Cardiac Muscle and Administration of Drug in Different Times for Reducing Cardiotoxicity of Adrianycin

Objective: To observe the cardiotoxicity of Adriamycin and investigate the method for reducing cardiotoxicity. Method: 243 patients with malignant tumors, having normal ECG before therapy, were treated by combined chemotherapy with Adriamycin primarily. The patients were divided into a therapy group and a control group. 168 patients in the therapy group were treated with coenzyme Q 10 and vitamin E for protecting cardiac muscle. According to different administration times of Adriamycin, the patients in the therapy group were subdivided into two following groups: 1.Group A (96 patients): Total dose of Adriamycin in the group was administrated one time a day. 2. Group B (72 patients): Total dose of Adriamycin in the group was administrated two times a day. 75 patients in the control group were only given Adriamycin one time a day. Abnormal ECG was served as the standard of positive cardiotoxicity. Result: 23 patients in group A had abnormal ECG (23.71%), while 27 patients in the control group had abnormal ECG (36.00%). There was significant difference in abnormal ECG between group A and the control group ( P <0.05). 13 patients in group B had abnormal ECG (18.05%), the patients with abnormal ECG in group A were significantly more compared with group B. Conclusion: Vitamin E, coenzyme Q 10 and Adriamycin given two times a day can reduce the cardiotoxicity of Adriamycin.