万爽力对宫颈癌化疗心脏保护作用
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摘要
目的化疗药物有一定的心脏毒性,万爽力作为一种营养心肌药物,能拮抗多种化疗药物引起的心脏毒性。本研究旨在探析万爽力预防宫颈癌化疗药物所致心脏毒性疗效。方法2017-09-01-2018-09-01选取山东省肿瘤医院80例确诊为宫颈癌接受顺铂联合紫杉醇化疗患者分为观察组(40例)和对照组(40例),对照组常规给予维生素C、维生素B6和辅酶Q10,观察组加用万爽力,比较用药后两组发生心电图、心功能及心脏超声的情况。结果观察组用药后心电图异常发生率为22.5%,低于对照组的50.0%,χ~2=6.545,P=0.011。心功能异常发生率为25%,低于对照组的52.5%,χ~2=6.373,P=0.012。观察组左心室收缩期内径(left ventricular internal dimension systole,LVISD)为(3.11±0.52)mm,优于对照组的(3.95±0.63)mm,t=6.503,P<0.001;观察组左心室舒张期内径(left ventricular internal dimension diastole,LVIDD)为(4.83±0.27)mm,优于对照组的(5.67±0.55)mm,t=8.671,P<0.001;观察组每搏输出量(stroke volume,SV)为(72.23±9.67)mL/min,优于对照组的(60.21±8.76)mL/min,t=5.850,P<0.001;观察组左室射血分数(left ventricular ejection fraction,LVEF)为(0.73±0.08)%,优于对照组的(0.61±0.11)%,t=5.580,P=0.001,差异均有统计学意义。结论万爽力可有效降低顺铂联合紫杉醇化疗所致心脏毒性。
OBJECTIVE Chemotherapeutic drugs have certain cardiotoxicity.Vasorel,as a myocardial nourishing drug,can antagonize the cardiotoxicity caused by a variety of chemotherapeutic drugs.The purpose of this study is to explore the efficacy of vasorel in preventing chemotherapy drug-induced cardiotoxicity in cervical cancer patients.METHODS From September 1,2017 to September 1,2018,80 patients with cervical cancer,who received cisplatin plus taxol in Shandong Tumor Hospital,were divided into observation group(40 cases)and control group(40 cases).The control group received routine administration of vitamin C,vitamin B6 and coenzyme Q10,and the observation group was added vasorel.The ECG,cardiac function and echocardiography were compared between the two groups.RESULTS The incidence of abnormal ECG in the observation group was 22.5%,lower than 50.0%in the control group(t=6.545,P=0.011).The incidence of cardiac dysfunction was 25%,lower than 52.5%in the control group(t=6.373,P=0.012).The left ventricular internal dimension systole(LVISD)of the observation group was(3.11±0.52)mm,better than that of the control group(3.95±0.63)mm(t=6.503,P=0.001).The left ventricular diastole(LVIDD)of the observation group was(4.83±0.27)mm,better than that of the control group(5.67±0.55)mm(t=8.671,P=0.001).And the stroke volume(SV)of the observation group was(72.23±9.67)ml/min,better than that of the control group(60.21±8.76)ml/min(t=5.850,P=0.001).The left ventricular ejection fraction(LVEF)in the observation group was(0.73±0.08)%,better than that in control group(0.61±0.11)%(t=5.580,P=0.001).The difference was statistically significant.CONCLUSION Vasorel is effective in preventing cardiotoxicity induced by cisplatin combined with taxol chemotherapy.
OBJECTIVE Chemotherapeutic drugs have certain cardiotoxicity.Vasorel,as a myocardial nourishing drug,can antagonize the cardiotoxicity caused by a variety of chemotherapeutic drugs.The purpose of this study is to explore the efficacy of vasorel in preventing chemotherapy drug-induced cardiotoxicity in cervical cancer patients.METHODS From September 1,2017 to September 1,2018,80 patients with cervical cancer,who received cisplatin plus taxol in Shandong Tumor Hospital,were divided into observation group(40 cases)and control group(40 cases).The control group received routine administration of vitamin C,vitamin B6 and coenzyme Q10,and the observation group was added vasorel.The ECG,cardiac function and echocardiography were compared between the two groups.RESULTS The incidence of abnormal ECG in the observation group was 22.5%,lower than 50.0%in the control group(t=6.545,P=0.011).The incidence of cardiac dysfunction was 25%,lower than 52.5%in the control group(t=6.373,P=0.012).The left ventricular internal dimension systole(LVISD)of the observation group was(3.11±0.52)mm,better than that of the control group(3.95±0.63)mm(t=6.503,P=0.001).The left ventricular diastole(LVIDD)of the observation group was(4.83±0.27)mm,better than that of the control group(5.67±0.55)mm(t=8.671,P=0.001).And the stroke volume(SV)of the observation group was(72.23±9.67)ml/min,better than that of the control group(60.21±8.76)ml/min(t=5.850,P=0.001).The left ventricular ejection fraction(LVEF)in the observation group was(0.73±0.08)%,better than that in control group(0.61±0.11)%(t=5.580,P=0.001).The difference was statistically significant.CONCLUSION Vasorel is effective in preventing cardiotoxicity induced by cisplatin combined with taxol chemotherapy.
引文
[1]El-Sawalhi MM.Exploring the protective role of apocynin,a specific NADPH oxidase inhibitor,in cisplatin-induced cardiotoxicity in rats[J].Chem Biol Interact,2014,207:58-66.
[2]Khan S,Chen CL,Brady MS,et al.Unstable angina associated with cisplatin and carboplatin in a patient with advanced melanoma[J].J Clin Oncol,2012,30(18):e163-164.
[3]Ryberg M.Recent advances in cardiotoxicity of anticancer therapies[J].Am Soc Clin Oncol Educ Book,2012:555-559.
[4]Lw-Friedrich I,von Bredow F.In vitro studies on the cardiotoxicity of chemotherapeutics[J].Chemotherapy,1990,36(6):416-421.
[5]Preston TJ,Abadi A,Wilson L.Mitochondrial contributions to cancer cell physiology:potential for drug development[J].Adv Drug Deliv Rev,2001,49(1-2):45-61.
[6]于淼,李辉,刘卫东.抗肿瘤药紫杉醇的不良反应及临床合理用药分析[J].医学理论与实践,2012,23(8):1022-1023.
[7]盛蕾,熊嘉玮,江雪梅,等.曲美他嗪对急性脑血管病患者的心肌保护作用[J].临床心血管病杂志,2009,25(5):386-387.
[8]Kantor PF,Lucien A,Kozak R.The antianginal drug trimetazidine shifts cardiac energy metabolism from fatty acid oxidation to glucose oxidation by inhibiting mitochondrial long-chain 3-ketoacyl coenzyme A thiolase[J].Circ Res,2000,86(5):580-588.
[9]Pascale C,Fornengo P,Epifani G,et al.Cardioprotection of trimetazidine and anthracycline-induced acute cardiotoxic effects[J].The Lancet,2002,359(9312):1153-1154.
[10]熊攀,周莉,董爱芝.曲美他嗪对急性冠脉综合征患者血清炎性因子水平的影响[J].山东医药,2008,48(44):33-34.
[11]梁桂英,杨兵生.曲美他嗪联合贝那普利治疗舒张性心力衰竭的临床疗效及安全性评价[J].中国临床药理学杂志,2015,31(13):1227-1229.
[12]Chu YS,Li DX,Zhang M.Trimetazidine hydrochloride as a new treatment for patients with peripheral vascular disease--an exploratory trial[J].Eur Rev Med Pharmacol Sci,2016,20(1):188-193.
[13]Zhong Y,Zhong P,He S,et al.Trimetazidine protects cardiomyocytes against hypoxia/reoxygenation injury by promoting AMP-activated protein kinase-dependent autophagic flux[J].J Cardiovasc Pharmacol,2017,69(6):389-397.
[14]杨娟,姜武忠.曲美他嗪联合小剂量卡维地洛对乳腺癌患者蒽环类药物化疗后心脏毒性防治效果分析[J].临床和实验医学杂志,2018,17(1):57-60.
[2]Khan S,Chen CL,Brady MS,et al.Unstable angina associated with cisplatin and carboplatin in a patient with advanced melanoma[J].J Clin Oncol,2012,30(18):e163-164.
[3]Ryberg M.Recent advances in cardiotoxicity of anticancer therapies[J].Am Soc Clin Oncol Educ Book,2012:555-559.
[4]Lw-Friedrich I,von Bredow F.In vitro studies on the cardiotoxicity of chemotherapeutics[J].Chemotherapy,1990,36(6):416-421.
[5]Preston TJ,Abadi A,Wilson L.Mitochondrial contributions to cancer cell physiology:potential for drug development[J].Adv Drug Deliv Rev,2001,49(1-2):45-61.
[6]于淼,李辉,刘卫东.抗肿瘤药紫杉醇的不良反应及临床合理用药分析[J].医学理论与实践,2012,23(8):1022-1023.
[7]盛蕾,熊嘉玮,江雪梅,等.曲美他嗪对急性脑血管病患者的心肌保护作用[J].临床心血管病杂志,2009,25(5):386-387.
[8]Kantor PF,Lucien A,Kozak R.The antianginal drug trimetazidine shifts cardiac energy metabolism from fatty acid oxidation to glucose oxidation by inhibiting mitochondrial long-chain 3-ketoacyl coenzyme A thiolase[J].Circ Res,2000,86(5):580-588.
[9]Pascale C,Fornengo P,Epifani G,et al.Cardioprotection of trimetazidine and anthracycline-induced acute cardiotoxic effects[J].The Lancet,2002,359(9312):1153-1154.
[10]熊攀,周莉,董爱芝.曲美他嗪对急性冠脉综合征患者血清炎性因子水平的影响[J].山东医药,2008,48(44):33-34.
[11]梁桂英,杨兵生.曲美他嗪联合贝那普利治疗舒张性心力衰竭的临床疗效及安全性评价[J].中国临床药理学杂志,2015,31(13):1227-1229.
[12]Chu YS,Li DX,Zhang M.Trimetazidine hydrochloride as a new treatment for patients with peripheral vascular disease--an exploratory trial[J].Eur Rev Med Pharmacol Sci,2016,20(1):188-193.
[13]Zhong Y,Zhong P,He S,et al.Trimetazidine protects cardiomyocytes against hypoxia/reoxygenation injury by promoting AMP-activated protein kinase-dependent autophagic flux[J].J Cardiovasc Pharmacol,2017,69(6):389-397.
[14]杨娟,姜武忠.曲美他嗪联合小剂量卡维地洛对乳腺癌患者蒽环类药物化疗后心脏毒性防治效果分析[J].临床和实验医学杂志,2018,17(1):57-60.