曲美他嗪防治表柔比星心肌毒性的临床观察

Clinical observation of the myocardial protective effect of trimetazidine on patients who accepted epidoxorubicin (EPI) chemotherapy

关键词:  曲美他嗪  表柔比星  心肌毒性

Key words:  trimetazidine  epidoxorubicin  cardiotoxicity

摘要:

目的　探讨曲美他嗪防治表柔比星心肌毒性的疗效。 　方法　117例乳腺癌根治术后患者分为试验组（60例）和对照组（57例）。两组患者均接受4周期含表柔比星的AC化疗方案，试验组加用曲美他嗪20 mg 3次/d。比较两组患者心脏彩超、心电图、血清肌钙蛋白I（cTNI）及心房利钠肽（BNP）水平。　结果　两组患者的年龄、LVEF、cTNI、BNP水平等基础临床资料无统计学差异。试验组心电图异常的比率较对照组明显减少（10% vs 24.6%，P<0.05）。对照组LVEF较试验组明显下降，（56.21±2.03）% vs （51.19±1.67）%，P<0.05。与对照组比较，试验组患者化疗后cTNI水平（0.42±0.04）μg/L vs （1.07±0.05）μg/L，P<0.05；及BNP水平（320.5±12.3）pg/mL vs （873±15.5）pg/mL，P<0.05，两者均降低。　结论　曲美他嗪可降低表柔比星的心肌毒性，对化疗期患者的心脏具有积极的保护作用。

Abstract:

Methods 117 breast cancer patients with the radical mastectomy were divided into two groups. Both group patients accepted 4 courses of EPI-contained AC chemotherapy. Patients in the experimental group accepted 20mg trimetazidine three times a day. The echocardiography and ECG were evaluated. The level of serum TNI and BNP were also studied.　Results There were no statistical differences between these two groups on clinical characteristic. Compared with the control group, the rate of abnormal ECG（10% vs 24.6%）, the level of serum cTNI （0.42±0.04）μg/L vs （1.07±0.05）μg/L and BNP （320.5±12.3） pg/dL vs （873±15.5） pg/dL were much less in the experimental group. LVEF of the experimental group was higher than the control group，（56.21±2.03）% vs （51.19±1.67）%，P<0.05. 　Conclusion Trimetazidine reduced cardiotoxicity of epidoxorubicin, and protected the heart during the chemotherapy period.