黄芪注射液/华蟾素注射液联合右丙亚胺对阿霉素相关性心脏毒性的保护作用

目的:探讨黄黄芪注射液/华蟾素注射液联合右丙亚胺对阿霉素相关性心脏毒性的保护作用,并与单用右丙亚胺对比研究。方法:120例采用含阿霉素化疗方案首次治疗的恶性肿瘤患者随机分为:A组:右丙亚胺组;B组:右丙亚胺与黄芪注射液联合治疗;C组:右丙亚胺与华蟾素注射液联合治疗组;D组:右丙亚胺与黄芪注射液及华蟾素注射液联合治疗组(每组各30例)。A组常规化疗前给予右丙亚胺静脉输注,B组常规化疗前给予右丙亚胺与黄芪联合治疗,C组常规化疗前给予右丙亚胺与华蟾素联合治疗,D组常规化疗前给予右丙亚胺、黄芪及华蟾素联合治疗,共4个周期。比较4组患者治疗前后心电图、肌酸激酶同工酶(CK-MB)和心肌肌钙蛋白Ⅰ(cTnⅠ),左室舒张末期内径(LVIDD),左射血分数(EF)。结果:经4个周期治疗后,D组无论是心电图异常发生率还是CK-MB、cTnⅠ、LVIDD、EF与另三组比较差异均有显著性(P < 0.05);而A、B、C 3组间患者的心电图异常发生率、CK-MB、cTnⅠ、LVIDD、EF无显著性差异(P > 0.05)。结论:黄芪和华蟾素注射液联合右丙亚胺可减低阿霉素所致心脏毒性作用,优于单用右丙亚胺。

Protective effects of Astragalus injection/Huachansu injection combined with dexrazoxane against adriamycin related cardiac toxicity

OBJECTIVE To investigate the protective effects of Astragalus injection/Huachansu injection combined with dexrazoxane against adriamycin related cardiac toxicity, and compare with the results obtained by singly using dexrazoxane. METHODS A total of 120 patients with malignant tumors treated by doxorubicin as the first chemotherapy were randomly divided into: group A: dexrazoxane group; group B: dexrazoxane combined with Astragalus; group C: dexrazoxane combined with Huachansu injection; group D: dexrazoxane combined with Astragalus and Huachansu injections; each group had 30 patients. Dexrazoxane injection as administered to patients in group A received before routine chemotherapy; dexrazoxane combined with Astragalus injection to patients in group B; dexrazoxane combined with Huachansu injection to patients in group C; and dexrazoxane combined with Astragalus and Huachansu injections to patients in group D. Electrocardiogram, creatine kinase isoenzyme MB (CK-MB) and cardiac troponin I (cTn I), brain natriuretic peptide precursor NT-proBNP, left ejection fraction (EF) were compared in patients between the four groups before and after therapy. RESULTS After treatment, group D had significantly different abnormal ECG, CK-MB, cTnI, LVIDD and EF compared with the other three groups (P>0.05). While groups B, C and A had no significantly different abnormal ECG rate, CK-MBm cTnI, LVIDD and EF (P<0.05). CONCLUSION Astragalus and cinobufotalin injections combined with dexrazoxane may reduce the adriamycin induced cardiotoxicity, superior to the single use of dexrazoxane.