表柔比星联用右丙亚胺和多柔比星脂质体对化疗所致心脏毒性的临床研究

目的观察表柔比星联用右丙亚胺和多柔比星脂质体对化疗所致心脏毒性的保护作用。方法将96例乳腺癌术后患者分为右丙亚胺组、多柔比星脂质体组和对照组,三组患者均接受以蒽环类药物为基础的术后辅助化疗方案4周期,通过监测各时期心电图异常率、心脏彩超左心室射血分数（LVEF）、短轴缩短率（SF）来评估心脏功能。结果对照组化疗后心电图异常率最高,右丙亚胺组、多柔比星脂质体组均能明显降低心电图异常率,且从化疗后1周期就显示出心脏保护作用;而LVEF及SF的变化在三组患者化疗前后差异无统计学意义（P〉0.05）。结论表柔比星化疗时加用DEX或者使用多柔比星脂质体对减轻蒽环类药物心脏毒性是有效且安全的。

Clinical study of chemotherapy-induced cardiotoxicity of epirubicin associated with dexrazoxane and li-posomal doxorubicin

Objective To observe the effect of epirubicin combined with dexrazoxane and more flexi- ble than the protective effect of liposomal doxorubicin on cardiac toxicity induced by chemotherapy. Methods 96 cases of postoperative breast cancer patients were divided into dexrazoxane group, liposomal doxorubicin group and control group, adjuvant chemotherapy in three patients were treated with anthracycline-based after 4 cycles, the abnormal rate of ECG monitoring in each period, left ventricle ejection fraction （LVEF color Doppler ultrasound）, fractional shortening （SF） to evaluate the heart function. Results in the control group after chemotherapy, the abnormal rate of ECG was highest, dexrazoxane group, doxorubicin can significantly re- duce the abnormal rate of ECG was star liposome group, and from the 1 cycle of chemotherapy showed protective effect on the heart; and the changes of LVEF and SF in three patients before and after chemotherapy group had no statistical differences （P 〉 0.05）. Conclusion Epirubicin chemotherapy with DEX or the use of liposomal doxorubicin on reducing anthracycline cardiotoxicity is safe and effective.