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目的:对右丙亚胺预防乳腺癌患者化疗所致心脏毒性的效果和经济性进行系统综述。方法:计算机检索Pubmed,Science Direct,The Cochrane Library,EMbase,中国知网数据库、万方数据库和维普中文科技期刊数据库,系统检索国内外公开发表的蒽环类药物联用右丙亚胺治疗乳腺癌的临床研究和经济学研究,并对其进行质量评价。结果:最终纳入9篇文献,包含6篇临床文献(7项随机对照试验)和3篇药物经济学文献。7项随机对照试验中,联用右丙亚胺治疗的患者出现心脏毒性和充血性心力衰竭的概率均显著低于单用蒽环类药物的患者。3篇药物经济学研究中,2篇研究显示相比单用蒽环类药物,蒽环类药物联用右丙亚胺治疗乳腺癌具有经济性,另1篇研究未指出其是否具有经济性。结论:右丙亚胺对于接受蒽环类药物化疗的乳腺癌患者有显著的心脏保护作用。但是,蒽环类药物联用右丙亚胺治疗乳腺癌的药物经济学研究极其有限,需要更多研究来验证。
OBJECTIVE: To systematically review the efficacy and economy of dexmedetamol in preventing chemotherapy-induced cardiotoxicity in breast cancer patients. Methods: We searched Pubmed, Science Direct, The Cochrane Library, EMbase, China Knowledge Network Database, Wanfang Database and VIP Chinese Science and Technology Periodical Database for the systematic search of domestic and foreign published anthracycline combined with dexrazoxane in the treatment of breast cancer Clinical research and economics research, and its quality evaluation. Results: Nine articles were finally included, including six clinical articles (seven randomized controlled trials) and three articles on pharmacoeconomics. In seven randomized controlled trials, patients treated with dexmedetamol had significantly lower rates of cardiotoxicity and congestive heart failure than those treated with anthracycline alone. Of the three pharmacoeconomic studies, two studies showed that anthracycline combined with dexrazoxane was more cost effective than anthracycline alone in the treatment of breast cancer, while another study did not indicate whether it was economical. Conclusion: D-imine has significant cardioprotective effects on breast cancer patients receiving anthracycline chemotherapy. However, the economics of anthracycline in the treatment of breast cancer with dexmedetamil is extremely limited and more studies are needed to verify this.