CAJ | 학술논문

目的：探讨右丙亚胺对接受蒽环类药物化疗的急性非淋巴细胞白血病患者的心肌保护作用。方法32例急性非淋巴细胞白血病患者随机分为实验组及对照组，每组16例。所有患者均采用含蒽环类药物的化疗方案进行治疗，实验组在用含蒽环类药物化疗方案的同时，加用右丙亚胺治疗；对照组仅采用含蒽环类药物化疗方案。化疗3个疗程，观察治疗前后各组患者的心电图异常率，B型脑利钠肽（BNP）、左心室射血分数及心肌肌钙蛋白的定性检测，并评估两组治疗效果。结果对照组患者化疗前后BNP分别为（102.98±5.67）×10-6 ug/ml和（168.46±7.75）×10-6 ug/ml，差异有统计学意义（P<0.05）；实验组患者化疗前后BNP分别为（103.02±6.42）×10-6 ug/ml和（112.78±6.69）×10-6 ug/ml，差异无统计学意义（P>0.05）。对照组患者化疗前后心肌肌钙蛋白T（cTnT）分别为（12.48±2.46）×10-3 ug/ml和（29.68±5.68）×10-3 ug/ml，差异有统计学意义（P<0.05）；实验组患者化疗前后cTnT分别为（12.73±2.27）×10-3 ug/ml和（14.34±5.12）×10-3 ug/ml，差异无统计学意义（P>0.05）。对照组患者化疗前后左室射血分数（LVEF）分别为（62.67±6.42）%和（53.39±5.57）%，差异有统计学意义（P<0.05）；实验组化疗前后LVEF分别为（63.18±5.97）%和（59.15±5.02）%，差异无统计学意义（P>0.05）。实验组与对照组心电图异常发生率分别为12.5%（2/16）和43.75%（7/16），差异有统计学意义（P<0.05）。化疗后两组治疗效果差异无统计学意义（P>0.05）。结论右丙亚胺对使用蒽环类药物化疗的急性非淋巴细胞白血病患者所致的心脏毒性具有保护作用，且不影响蒽环类药物抗肿瘤疗效。
목적：탐토우병아알대접수은배류약물화료적급성비림파세포백혈병환자적심기보호작용。방법32례급성비림파세포백혈병환자수궤분위실험조급대조조，매조16례。소유환자균채용함은배류약물적화료방안진행치료，실험조재용함은배류약물화료방안적동시，가용우병아알치료；대조조부채용함은배류약물화료방안。화료3개료정，관찰치료전후각조환자적심전도이상솔，B형뇌리납태（BNP）、좌심실사혈분수급심기기개단백적정성검측，병평고량조치료효과。결과대조조환자화료전후BNP분별위（102.98±5.67）×10-6 ug/ml화（168.46±7.75）×10-6 ug/ml，차이유통계학의의（P<0.05）；실험조환자화료전후BNP분별위（103.02±6.42）×10-6 ug/ml화（112.78±6.69）×10-6 ug/ml，차이무통계학의의（P>0.05）。대조조환자화료전후심기기개단백T（cTnT）분별위（12.48±2.46）×10-3 ug/ml화（29.68±5.68）×10-3 ug/ml，차이유통계학의의（P<0.05）；실험조환자화료전후cTnT분별위（12.73±2.27）×10-3 ug/ml화（14.34±5.12）×10-3 ug/ml，차이무통계학의의（P>0.05）。대조조환자화료전후좌실사혈분수（LVEF）분별위（62.67±6.42）%화（53.39±5.57）%，차이유통계학의의（P<0.05）；실험조화료전후LVEF분별위（63.18±5.97）%화（59.15±5.02）%，차이무통계학의의（P>0.05）。실험조여대조조심전도이상발생솔분별위12.5%（2/16）화43.75%（7/16），차이유통계학의의（P<0.05）。화료후량조치료효과차이무통계학의의（P>0.05）。결론우병아알대사용은배류약물화료적급성비림파세포백혈병환자소치적심장독성구유보호작용，차불영향은배류약물항종류료효。
Objective To evaluate the cardioprotective effects of dexrazoxane (DEX) on acute myelogenous leukemia patients who received anthracycline-containing chemotherapy. Methods A total of 32 acute myelogenous leukemia patients were randomly divided into two groups:the experimental group and the control group.The experimental group of 16 cases treated with EPI plus DEX as adjuvant chemotherapy regimen,and the control group of 16 cases treated with EPI without DEX.All patients received three cycles of adjuvant chemotherapy,compare changes of electrocardiogram、BNP、cTnT and LVEF before and after chemotherapy,and compare the treatment effect between the two groups. Results Brain natriuretic peptide (BNP)before chemotherapy and after three cycles of chemotherapy in the control group was (102.98±5.67)×10-6 ug/ml and (168.46±7.75)×10-6 ug/ml,respectively,with a significant difference between them (p<0.05) .It in the experimental group was (103.02±6.42)×10-6 ug/ml and (112.78±6.69)×10-6 ug/ml,respectively,without a significant difference(P>0.05) .Cardiac troponin T(cTnT) before chemotherapy and after three cycles of chemotherapy in the control group was (12.48±2.46)×10-3ug/ml和(29.68 ±5.68)×10-3ug/ml,respectively,with a significant difference between them(p<0.05) .It in the experimental group was (12.73±2.27)×10-3ug/ml和(14.34±5.12)×10-3ug/ml,respectively,without a significant difference(P>0. 05).The left ventricular ejection fraction (LVEF) before chemotherapy and after three cycles of chemotherapy in the control group was (62.67±6.42)%and (53.39 ±5.57)%,respectively,with a significant difference between them(P<0.05).It in the experimental group was (63.18±5.97)%和(59.15±5.02)%,respectively,without a significant difference (P>0.05) .The experimental group and control group in incidence of abnormal ecg was 12.5%(2/16) and 43.75%(7/16) ,with a significant difference between them(p<0.05).The treatment effect between the experimental group and control group without a significant difference (P>0.05). Conclusion Dexrazoxane has the pertective effect on cardiotoxicity in acute myelogenous leukemia patients who received anthracycline-containing chemotherapy,and does not affect the antitumor efficacy anthracycline-based drugs.