右丙亚胺对复发平滑肌肉瘤患者化疗的心脏保护作用研究

目的：观察右丙亚胺（dexrazoxane,DEX）对平滑肌肉瘤复发患者接受蒽环类药物辅助化疗所致心脏毒副反应的保护作用.方法：将29例复发平滑肌肉瘤患者随机分成治疗组（DEX组）和对照组.两组患者均接受以蒽环类药物为基础的辅助化疗5个周期,治疗组在使用蒽环类药物化疗的基础上加用右丙亚胺（右丙亚胺∶表柔比星=10∶1）,在第一次应用蒽环类药物时即给予右丙亚胺.监测各时期心肌肌钙蛋白（cTnT）和左心室射血分数（LEVF）,统计临床心功能不全的发生率以进行心脏功能评估,同时观察治疗的非心脏毒副反应及疗效.结果：两组患者在年龄、体重、ECOG评分等方面没有统计学差异（P＞0.05）.从表柔比星（EPI）治疗的第一个周期开始cTnT明显上升,到治疗结束时达到最高,直到治疗后2年仍然维持在较高水平.加用DEX组（即治疗组）在治疗期间及治疗后cTnT水平都较低,两组比较差异有显著性（P＜0.05）.而LEVF在两组的各个治疗阶段水平都没有统计学差异（P＞0.05）.两组的非心脏毒副反应没有差异.结论：EPI从第一次应用时对心脏便产生了明显的毒副反应,加用DEX后可以降低这种心脏毒副反应.

Protective effect of dexrazoxane on anthracyclines cardio-toxicity of relapse sarcoma patients treated with chemotherapy

Objective：To observe the protective effect of dexrazoxane （DEX） on cardio-toxicity induced by anthracyclines treated for the relapse sarcoma of smooth muscle.Methods：All 29 relapse sarcoma patients of smooth muscle were randomly divided into DEX group and control group.Both groups received 5 cycles chemotherapy therapy regimen based on anthracyclines.DEX group plus dexrazoxane （DEX∶ EPI =10∶1） since the first use of anthracyclines.Cardiofunction was evaluated by monitoring cTnT and LEVF during every periods and statistic incidence rate of CHF and observation the non-cardiotoxicity and clinical effect were observed.Results：There was no significant difference between two groups in age,weight,ECOG and stages.cTnT had obviously increased from the first cycle of EPI treatment and reach maximum at the end of treatment.cTnT had still maintained at a relatively high level until two years after treatment.However cTnT had maintained at a relatively low level in DEX group during treatment and after treatment.The difference between the two groups was significant （P ＜ 0.05）.The difference of the LEVF and non-cardiotoxicity in two groups was not significant（P ＞ 0.05）.Conclusion：EPI causes obviously cardiotoxicity since the first usage,but EPI plus DEX could decrease this cardiotoxicity.