丹红注射液对恶性肿瘤患者氟尿嘧啶所致心脏毒性的保护作用研究
|
摘要
目的探讨丹红注射液对恶性肿瘤患者氟尿嘧啶所致心脏毒性的保护作用。方法选取2016年1月—2017年5月在石家庄市第一医院采用含5-氟尿嘧啶FOLFOX4方案进行化疗的恶性肿瘤患者100例,采用随机数字表法分为对照组和观察组,每组50例。对照组患者采用含5-氟尿嘧啶FOLFOX4方案进行化疗,观察组患者在对照组基础上加用丹红注射液;两组患者均连续治疗8周。比较两组患者心电图异常情况、治疗前后超声心动图检查指标及心肌酶学指标,并记录观察组患者治疗期间丹红注射液相关不良反应发生情况。结果观察组患者心电图异常发生率低于对照组(P<0.05)。治疗前两组患者左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、舒张早期左房室瓣血流速度/舒张晚期左房室瓣血流速度(E/A比值)、左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)比较,差异无统计学意义(P>0.05);治疗后观察组患者LVEDD、LVESD短于对照组,E/A比值、LVEF高于对照组(P<0.05),而两组患者LVFS比较,差异无统计学意义(P>0.05)。治疗前两组患者肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)比较,差异无统计学意义(P>0.05);治疗后观察组患者CK-MB、LDH低于对照组(P<0.05)。观察组患者治疗期间无一例出现丹红注射液相关不良反应。结论丹红注射液可有效减少采用含5-氟尿嘧啶FOLFOX4方案进行化疗的恶性肿瘤患者心电图异常的发生,有利于减轻氟尿嘧啶所致心脏毒性及心肌损伤,具有一定保护作用且安全性较高。
Objective To investigate the protective effect of Danhong injection on fluorouracil-induced cardiac toxicity in patients with malignant neoplasms. Methods A total of 100 malignant neoplasms patients treated by FOLFOX4 regimen(including 5-fluorouracil)were selected in the First Hospital of Shijiazhuang from January 2016 to May 2017,and they were divided into control group and observation group according to random number table,each of 50 cases. Patients in control group received FOLFOX4 regimen(including 5-fluorouracil)only,while patients in observation group received extra Danhong injection based on that of control group;both groups continuously treated for 8 weeks. Incidence of electrocardiographic abnormality,ultrasonic cardiogram examination results and myocardial enzymes indicators before and after treatment were compared between the two groups,and incidence of Danhong injection related adverse reactions was observed during treatment. Results Incidence of electrocardiographic abnormality in observation group was statistically significantly lower than that in control group(P<0.05). No statistically significant differences of LVEDD,LVESD,E/A ratio,LVEF or LVFS was found between the two groups before treatment,nor was LVFS after treatment(P>0.05);after treatment,LVEDD and LVESD in observation group were statistically significantly shorter than those in control group,while E/A ratio and LVEF in observation group were statistically significantly higher than those in control group(P<0.05). No statistically significant differences of CKMB or LDH was found between the two groups before treatment(P>0.05),while CK-MB and LDH in observation group were statistically significantly lower than those in control group after treatment(P<0.05). No one in observation group occurred Danhong injection related adverse reactions during treatment. Conclusion Danhong injection can effectively reduce the risk of electrocardiographic abnormality in malignant neoplasms patients treated by FOLFOX4 regimen(including 5-fluorouracil),is helpful to relieve the fluorouracil-induced cardiac toxicity and myocardial damage,with certain protective effect and relatively high safety.
Objective To investigate the protective effect of Danhong injection on fluorouracil-induced cardiac toxicity in patients with malignant neoplasms. Methods A total of 100 malignant neoplasms patients treated by FOLFOX4 regimen(including 5-fluorouracil)were selected in the First Hospital of Shijiazhuang from January 2016 to May 2017,and they were divided into control group and observation group according to random number table,each of 50 cases. Patients in control group received FOLFOX4 regimen(including 5-fluorouracil)only,while patients in observation group received extra Danhong injection based on that of control group;both groups continuously treated for 8 weeks. Incidence of electrocardiographic abnormality,ultrasonic cardiogram examination results and myocardial enzymes indicators before and after treatment were compared between the two groups,and incidence of Danhong injection related adverse reactions was observed during treatment. Results Incidence of electrocardiographic abnormality in observation group was statistically significantly lower than that in control group(P<0.05). No statistically significant differences of LVEDD,LVESD,E/A ratio,LVEF or LVFS was found between the two groups before treatment,nor was LVFS after treatment(P>0.05);after treatment,LVEDD and LVESD in observation group were statistically significantly shorter than those in control group,while E/A ratio and LVEF in observation group were statistically significantly higher than those in control group(P<0.05). No statistically significant differences of CKMB or LDH was found between the two groups before treatment(P>0.05),while CK-MB and LDH in observation group were statistically significantly lower than those in control group after treatment(P<0.05). No one in observation group occurred Danhong injection related adverse reactions during treatment. Conclusion Danhong injection can effectively reduce the risk of electrocardiographic abnormality in malignant neoplasms patients treated by FOLFOX4 regimen(including 5-fluorouracil),is helpful to relieve the fluorouracil-induced cardiac toxicity and myocardial damage,with certain protective effect and relatively high safety.
引文
[1]丁欣,陈国江.5-氟尿嘧啶化疗耐药的研究进展[J].国际药学研究杂志,2017,44(6):491-494.DOI:10.13220/j.cnki.jipr.2017.06.004.
[2]TURAN T,AGAC M T,AYKAN A?,et al.Usefulness of Heart-Type Fatty Acid-Binding Protein and Myocardial Performance Index for Early Detection of 5-Fluorouracil Cardiotoxicity[J].Angiology,2017,68(1):52-58.DOI:10.1177/0003319716637516.
[3]POLK A,VISTISEN K,VAAGE-NILSEN M,et al.A systematic review of the pathophysiology of 5-fluorouracil-induced cardiotoxicity[J].BMC Pharmacol Toxicol,2014,15(1):47-50.DOI:10.1186/2050-6511-15-47.
[4]LESTUZZI C,VACCHER E,TALAMINI R,et al.Effort myocardial ischemia during chemotherapy with 5-fluorouracil:an underestimated risk[J].Ann Oncol,2014,25(5):1059-1064.DOI:10.1093/annonc/mdu055.
[5]BEN-YAKOV M,MATTU A,BRADY W J,et al.Prinzmetal angina(Coronary vasospasm)associated with 5-fluorouracil chemotherapy[J].Am J Emerg Med,2017,35(7):1038.e3-1038.e5.DOI:10.1016/j.ajem.2017.02.046.
[6]SANEEYMEHRI S S,MARKEY K R,MAHIPAL A.Paradoxical effect of capecitabine in 5-fluorouracil-induced cardiotoxicity:A case vignette and literature review[J].J Oncol Pharm Pract,2016,22(3):552-555.DOI:10.1177/1078155215579303.
[7]张毅,赵阳,杨天仁.中医药在肿瘤化学治疗中的减毒作用研究进展[J].中国医学创新,2015,12(9):153-156.DOI:10.3969/j.issn.1674-4985.2015.09.052.
[8]VARGO C A,BLAZER M,REARDON J,et al.Successful Completion of Adjuvant Chemotherapy in a Patient With Colon Cancer Experiencing 5-Fluorouracil-Induced Cardiac Vasospasm[J].Clin Colorectal Cancer,2016,15(2):e61-63.DOI:10.1016/j.clcc.2015.10.004.
[9]杨晨光,许鹏,谢燕华,等.氟尿嘧啶类药物的性味辨析初探[J].医学争鸣,2013,4(4):33-35.DOI:10.13276/j.issn.1674-8913.2013.04.005.
[10]刘齐林,张静术.丹红注射液治疗心绞痛的临床疗效观察[J].中国医药指南,2011,9(28):136-137.DOI:10.3969/j.issn.1671-8194.2011.28.100.
[11]张楠,王敬然,赵亚红,等.丹红注射液对5-氟尿嘧啶所致心脏毒性的保护作用研究[J].中西医结合心脑血管病杂志,2016,14(17):2026-2028.DOI:10.3969/j.issn.1672-1349.2016.17.023.
[12]彭丹,覃松柏,李松.丹红注射液对冠心病患者血管功能及血清炎性因子水平的影响[J].实用心脑肺血管病杂志,2018,26(3):72-74.DOI:10.3969/j.issn.1008-5971.2018.03.020.
[13]杨迎伟,张爱民,李亚梅,等.丹红注射液联合依达拉奉治疗急性脑梗死的临床疗效[J].实用心脑肺血管病杂志,2017,25(11):83-85.DOI:10.3969/j.issn.1008-5971.2017.11.023.
[14]赵静,陈晨.超声心动图与心电图对乳腺癌患者综合治疗后心脏损伤的评估[J].中国全科医学,2015,18(35):4313-4316.DOI:10.3969/j.issn.1007-9572.2015.35.010.
[15]叶世权,马东明,杨军.丹红注射液联合氯吡格雷对急性冠脉综合征患者经皮冠状动脉介入治疗术后血清内皮素1、一氧化氮水平的影响[J].实用心脑肺血管病杂志,2017,25(6):148-150.DOI:10.3969/j.issn.1008-5971.2017.06.043.
[16]宋晓燕.丹红注射液对慢性心力衰竭患者心功能,内皮功能及血浆NPY水平的影响[J].中国中医药科技,2015,22(4):415-416.
[17]殷英,卫国,王艳华,等.丹红注射液促进心梗模型大鼠缺血心肌血管新生[J].中成药,2016,38(9):1893-1897.DOI:10.3969/j.Issn.1001-1528.2016.09.003.
[2]TURAN T,AGAC M T,AYKAN A?,et al.Usefulness of Heart-Type Fatty Acid-Binding Protein and Myocardial Performance Index for Early Detection of 5-Fluorouracil Cardiotoxicity[J].Angiology,2017,68(1):52-58.DOI:10.1177/0003319716637516.
[3]POLK A,VISTISEN K,VAAGE-NILSEN M,et al.A systematic review of the pathophysiology of 5-fluorouracil-induced cardiotoxicity[J].BMC Pharmacol Toxicol,2014,15(1):47-50.DOI:10.1186/2050-6511-15-47.
[4]LESTUZZI C,VACCHER E,TALAMINI R,et al.Effort myocardial ischemia during chemotherapy with 5-fluorouracil:an underestimated risk[J].Ann Oncol,2014,25(5):1059-1064.DOI:10.1093/annonc/mdu055.
[5]BEN-YAKOV M,MATTU A,BRADY W J,et al.Prinzmetal angina(Coronary vasospasm)associated with 5-fluorouracil chemotherapy[J].Am J Emerg Med,2017,35(7):1038.e3-1038.e5.DOI:10.1016/j.ajem.2017.02.046.
[6]SANEEYMEHRI S S,MARKEY K R,MAHIPAL A.Paradoxical effect of capecitabine in 5-fluorouracil-induced cardiotoxicity:A case vignette and literature review[J].J Oncol Pharm Pract,2016,22(3):552-555.DOI:10.1177/1078155215579303.
[7]张毅,赵阳,杨天仁.中医药在肿瘤化学治疗中的减毒作用研究进展[J].中国医学创新,2015,12(9):153-156.DOI:10.3969/j.issn.1674-4985.2015.09.052.
[8]VARGO C A,BLAZER M,REARDON J,et al.Successful Completion of Adjuvant Chemotherapy in a Patient With Colon Cancer Experiencing 5-Fluorouracil-Induced Cardiac Vasospasm[J].Clin Colorectal Cancer,2016,15(2):e61-63.DOI:10.1016/j.clcc.2015.10.004.
[9]杨晨光,许鹏,谢燕华,等.氟尿嘧啶类药物的性味辨析初探[J].医学争鸣,2013,4(4):33-35.DOI:10.13276/j.issn.1674-8913.2013.04.005.
[10]刘齐林,张静术.丹红注射液治疗心绞痛的临床疗效观察[J].中国医药指南,2011,9(28):136-137.DOI:10.3969/j.issn.1671-8194.2011.28.100.
[11]张楠,王敬然,赵亚红,等.丹红注射液对5-氟尿嘧啶所致心脏毒性的保护作用研究[J].中西医结合心脑血管病杂志,2016,14(17):2026-2028.DOI:10.3969/j.issn.1672-1349.2016.17.023.
[12]彭丹,覃松柏,李松.丹红注射液对冠心病患者血管功能及血清炎性因子水平的影响[J].实用心脑肺血管病杂志,2018,26(3):72-74.DOI:10.3969/j.issn.1008-5971.2018.03.020.
[13]杨迎伟,张爱民,李亚梅,等.丹红注射液联合依达拉奉治疗急性脑梗死的临床疗效[J].实用心脑肺血管病杂志,2017,25(11):83-85.DOI:10.3969/j.issn.1008-5971.2017.11.023.
[14]赵静,陈晨.超声心动图与心电图对乳腺癌患者综合治疗后心脏损伤的评估[J].中国全科医学,2015,18(35):4313-4316.DOI:10.3969/j.issn.1007-9572.2015.35.010.
[15]叶世权,马东明,杨军.丹红注射液联合氯吡格雷对急性冠脉综合征患者经皮冠状动脉介入治疗术后血清内皮素1、一氧化氮水平的影响[J].实用心脑肺血管病杂志,2017,25(6):148-150.DOI:10.3969/j.issn.1008-5971.2017.06.043.
[16]宋晓燕.丹红注射液对慢性心力衰竭患者心功能,内皮功能及血浆NPY水平的影响[J].中国中医药科技,2015,22(4):415-416.
[17]殷英,卫国,王艳华,等.丹红注射液促进心梗模型大鼠缺血心肌血管新生[J].中成药,2016,38(9):1893-1897.DOI:10.3969/j.Issn.1001-1528.2016.09.003.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |