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目的研究参麦注射液对蒽环类药物所致心脏毒性的预防作用。方法 96例使用蒽环类药物治疗的恶性肿瘤患者,随机分为预防组(50例)和对照组(46例)。两组均采用以蒽环类药物为主的一线联合化疗方案,同一病种所选用方案相同,对照组仅采用化疗药,预防组加用参麦注射液,其他水化、止吐、支持及对症治疗措施均相同。3个周期后评价两组的疗效。结果治疗前两组患者的心电图及心功能均为正常,治疗后预防组4例出现胸憋、气短、心悸等不适感,均在14 d内恢复;对照组20例出现胸憋、气短、心悸等不适感,其中3例出现阵发性呼吸困难,经营养心肌治疗后1个月内均有不同程度的改善;两组比较差异具有统计学意义(χ~2=16.08,P<0.05)。两组心电图表现、心律失常及心功能分级情况、治疗后丙氨酸氨基转移酶、磷酸肌酸激酶、肌酸激酶、乳酸脱氢酶水平比较差异均具有统计学意义(P<0.05);两组治疗前丙氨酸氨基转移酶、磷酸肌酸激酶、肌酸激酶、乳酸脱氢酶水平比较差异均无统计学意义(P>0.05)。结论参麦注射液对蒽环类化疗药所致心脏毒性具有明显的预防作用,值得临床推广。
Objective To study the preventive effect of Shenmai injection on the cardiotoxicity induced by anthracyclines. Methods A total of 96 patients with malignant tumor treated with anthracycline were randomly divided into prevention group (n = 50) and control group (n = 46). Anthracycline-based first-line combination chemotherapy was used in both groups, with the same choice of regimens for the same disease type. The control group was treated with chemotherapeutic drugs only. The prevention group was treated with Shenmai injection, other hydration, antiemetic, Symptomatic treatment are the same. The efficacy of both groups was evaluated after 3 cycles. Results Before treatment, electrocardiogram and cardiac function were normal in the two groups. In the prevention group, 4 cases had discomfort such as chest and breath, shortness of breath, palpitations and so on, which recovered within 14 days. In the control group, 20 cases had chest and breath, shortness of breath and heart palpitations 3 cases had paroxysmal dyspnea and improved within 1 month after treatment of myocardial infarction. The difference between the two groups was statistically significant (χ ~ 2 = 16.08, P <0.05). Electrocardiogram, arrhythmia and cardiac function in two groups were statistically significant (P <0.05). After treatment, the levels of alanine aminotransferase, creatine phosphokinase, creatine kinase and lactate dehydrogenase were significantly different (P <0.05) Group before treatment, alanine aminotransferase, creatine phosphokinase, creatine kinase, lactate dehydrogenase levels were no significant difference (P> 0.05). Conclusion Shenmai injection on anthracycline-induced cardiotoxicity has a significant preventive effect, is worth clinical promotion.