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目的评价中药注射剂对蒽环类药物所致心脏毒性的保护作用。方法 120例肿瘤患者被随机分为A、B、C、D四组,每组30例。所有患者均采用含蒽环类药物的化疗方案进行治疗,A组、B组、C组、D组的患者分别在化疗的基础上加用黄芪注射液、参麦注射液、右丙亚胺及中药注射剂联合右丙亚胺,共治疗4个周期(28天一个周期)。观察治疗前后各组患者的心电图变化、左心室射血分数及心肌肌钙蛋白的定性检测。结果治疗后,D组异常心电图患者的比例显著低于A、B、C三组(P分别为0.02,0.04,0.04),但是A、B、C三组之间两两比较差异无统计学意义(P分别为0.77,0.77,1.00);A、B、C三组患者的左心室射血分数显著低于治疗前(P=0.00),D组患者的左心室射血分数与治疗前比较差异无统计学意义(P=0.06),但是显著高于A、B、C三组(P=0.00);A、B、C、D四组间异常心肌肌钙蛋白患者的比例比较差异无统计学意义(P=0.63)。结论黄芪注射液和参麦注射液对蒽环类药物所致心脏毒性有一定的保护作用,其疗效与右丙亚胺相当,且与右丙亚胺具有协同作用。
Objective To evaluate the protective effect of Chinese medicine injection on the cardiotoxicity caused by anthracyclines. Methods 120 patients with cancer were randomly divided into A, B, C, D four groups, 30 cases in each group. All patients were treated with anthracycline-containing chemotherapy regimen. Patients in groups A, B, C and D were treated with astragalus injection, Shenmai injection, Chinese medicine injection of dexrazoxane, a total of 4 cycles (28 days a cycle). Electrocardiogram changes, left ventricular ejection fraction and cardiac troponin were detected qualitatively before and after treatment in each group. Results After treatment, the proportion of patients with abnormal ECG in group D was significantly lower than that in group A, B and C (P = 0.02, 0.04 and 0.04, respectively), but there was no significant difference between groups A, B and C (P = 0.77, 0.77, 1.00 respectively). The left ventricular ejection fraction in group A, B and C was significantly lower than that before treatment (P = 0.00). The left ventricular ejection fraction in group D was significantly lower than that before treatment (P = 0.06), but significantly higher than those in A, B and C groups (P = 0.00). There was no significant difference in the proportion of abnormal cardiac troponin between A, B, C and D Significance (P = 0.63). Conclusion Astragalus injection and Shenmai injection have certain protective effect on the cardiotoxicity induced by anthracyclines, and their efficacy is comparable to that of dexrazoxane and synergistic effect with dexrazoxane.