右丙亚胺联合参麦注射液对减少急性白血病化疗中心脏毒性的影响

目的观察比较右丙亚胺注射液单用、参麦注射液单用及两药联合使用对急性白血病患者化疗期间心脏毒性的影响.方法将105例已明确诊断为急性白血病的患者随机分为3组,每组35例,每组患者均应用含有蒽环类药物的化疗方案.A组(右丙亚胺组)在应用蒽环类药物化疗前30 min将右丙亚胺注射液快速静脉滴注;B组(参麦注射液组)对化疗患者给予参麦注射液保护心脏治疗,用法为50 mg/d静脉滴注;C组(联合用药组)在化疗同时联合应用右丙亚胺及参麦注射液保护心脏,每组药物均在化疗期间使用,化疗结束后停止使用.结果比较3组患者化疗前后的心电图、心肌酶及左心室射血分数变化,观察其心脏损害的程度.结果表明:C组患者各种心脏损害的指标均低于A,B两组.结论右丙亚胺及参麦注射液联合应用对于接受以蒽环类药物为基础的化疗方案的患者能明显减轻其心脏毒性作用,可作为降低蒽环类药物心脏毒性的新途径.

Effect of Combination of Dexrazoxane and Shenmaion Injection on Reducing Cardiac Toxicity during Acute Leukemia Chemotherapy

Objective To observe and compare the effects of dexrazoxane and Shenmai injection on cardiac toxicity during acute leukemia chemotherapy. Method 105 patients diagnosed as acute leukemia were randomly divided into three groups, with 35 patients in each group. All the patients accepted chemotherapy with anthracycline. Group A:Dexrazoxane group, dexrazoxane injection was rapidly administrated 30 minutes before chemotherapy. Group B:Shenmai injection group,the patients were given Shenmai intravenous infusion to protect their hearts with 50 mg per day. Group C:combination group,dexrazoxane and Shenmai injections were combined to protect heart during chemotherapy. All the injections were administrated during chemotherapy, and were removed at the end of the treatment. Results Compared the changes of myocardial enzyme amount,ECG and left ventricular ejection fraction in the patients,and observed the degree and proportion of heart damage. The results showed that the heart damage index of group C was lower than that of group A and B. Conclusion The combination of dexrazoxane and Shenmai injections can significantly reduce cardiac toxicity in the patients accepted chemotherapy based on anthracycline,which will provide a new way to reduce the cardiotoxicity of anthracycline.