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目的:探讨参麦注射液对乳腺癌患者术后化疗导致心肌损害的疗效以及对氧化应激的影响。方法:98例乳腺癌术后患者参照数字表法随机分为治疗组和对照组,各49例;对照组采用化疗方案[CEF,环磷酰胺(CTX)75 mg·m-2+表柔比星(EPI)60 mg·m-2+氟尿嘧啶500 mg·m-2],21 d为1个周期,1次/周期,共6个周期;治疗组在对照组基础上给予参麦注射液治疗,60 m L/次,用5%葡萄糖注射液500 m L稀释静脉滴注,于化疗前1 d开始给予,7次/周期;化疗结束后继续给予1周治疗。比较两组中医症状积分和心功能状况,检测两组血清肌钙蛋白I(c Tn I)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、总超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)、丙二醛(MDA)水平。结果:化疗结束时和化疗后1周,治疗组中医症状积分均明显低于对照组(P<0.01);化疗结束时和化疗后1周,治疗组舒张早期/舒张晚期最大血流速度(E/A)和左室射血分数(LVEF)均明显高于对照组(P<0.01);化疗结束时和化疗后1周,治疗组c Tn I,CK,CK-MB和MDA水平均明显低于对照组,而SOD和GSH明显高于对照组,差异有统计学意义(P<0.01)。结论:参麦注射液对乳腺癌术后患者化疗治疗导致心肌损害具有明显保护作用,其机制可能与改善氧化应激状态有关。
Objective: To investigate the effect of Shenmai injection on postoperative chemotherapy-induced myocardial damage in breast cancer patients and its effect on oxidative stress. Methods: Ninety-nine patients with breast cancer were randomly divided into treatment group (n = 49) and control group (n = 49). The control group was treated with CEF, CTX 75 mg · m- (EPI) 60 mg · m-2 and fluorouracil 500 mg · m-2], 21 days for 1 cycle, 1 time / cycle for 6 cycles. The treatment group was given Shenmai injection on the basis of the control group , 60 m L / time, with 5% dextrose injection 500 m L diluted intravenous infusion, 1 d before chemotherapy began to give, 7 times / cycle; continued after chemotherapy for 1 week treatment. The scores of TCM symptom scores and cardiac function were compared between the two groups. Serum levels of cTn I, CK, CK-MB and total superoxide dismutase (SOD), reduced glutathione (GSH) and malondialdehyde (MDA). Results: At the end of chemotherapy and 1 week after chemotherapy, the scores of TCM symptoms in the treatment group were significantly lower than those in the control group (P <0.01). At the end of chemotherapy and 1 week after chemotherapy, the maximum diastolic / / A) and left ventricular ejection fraction (LVEF) were significantly higher than those in the control group (P <0.01). At the end of chemotherapy and 1 week after chemotherapy, the levels of cTn I, CK, CK-MB and MDA in the treatment group were significantly lower In the control group, and SOD and GSH were significantly higher than the control group, the difference was statistically significant (P <0.01). Conclusion: Shenmai injection has a significant protective effect on myocardial injury caused by chemotherapy in breast cancer patients. The mechanism may be related to the improvement of oxidative stress.