CAJ | 학술논문

目的：表阿霉素在乳腺癌治疗中占有重要地位，其所诱导的心脏毒性是其临床应用的主要限制性因素，本研究旨在观察ω-3鱼油对表阿霉素所诱导的心肌损害的保护性作用。方法先比较40例应用表阿霉素治疗的乳腺癌患者与40名社区正常体检女性的心脏事件发生率。根据纳入标准，选取120例乳腺癌术后辅助化疗患者，随机分为标准治疗组和ω-3鱼油补充组，比较化疗前后两组患者心电图、心肌酶谱、C-反应蛋白（CRP）、白介素6（IL-6）、心脏超声及心脏相关症状的变化。结果应用表阿霉素化疗的人群心脏事件发生率（30.0%）高于正常对照人群（10.0%），两组间差异有统计学意义（P<0.05）。加用ω-3鱼油组较标准治疗组在心电图改变、心肌酶、CRP、白介素6变化、左室射血分数、心脏症状方面均有降低，其中CRP、白介素6的变化差异具有统计学意义（P<0.05）。结论在应用含表阿霉素的化疗方案对乳腺癌患者进行治疗时，在标准治疗基础上加用ω-3鱼油可减轻表阿霉素所诱导的心肌损害。
목적：표아매소재유선암치료중점유중요지위，기소유도적심장독성시기림상응용적주요한제성인소，본연구지재관찰ω-3어유대표아매소소유도적심기손해적보호성작용。방법선비교40례응용표아매소치료적유선암환자여40명사구정상체검녀성적심장사건발생솔。근거납입표준，선취120례유선암술후보조화료환자，수궤분위표준치료조화ω-3어유보충조，비교화료전후량조환자심전도、심기매보、C-반응단백（CRP）、백개소6（IL-6）、심장초성급심장상관증상적변화。결과응용표아매소화료적인군심장사건발생솔（30.0%）고우정상대조인군（10.0%），량조간차이유통계학의의（P<0.05）。가용ω-3어유조교표준치료조재심전도개변、심기매、CRP、백개소6변화、좌실사혈분수、심장증상방면균유강저，기중CRP、백개소6적변화차이구유통계학의의（P<0.05）。결론재응용함표아매소적화료방안대유선암환자진행치료시，재표준치료기출상가용ω-3어유가감경표아매소소유도적심기손해。
Objective To observe the protective effect of omega-3 fish oil for epirubicin induced myocardial damage , because of the important position of epirubicin in the treatment of breast cancer , whose cardiotoxicity was the main restrictive factor. Methods Compared the cardiac events incidence between 40 cases breast cancer patients who used epirubicin in the treatment and 40 community health women. According to the inclusive criteria , 120 cases that conducted adjuvant chemotherapy after breast cancer operation were selected, and then divided into two groups randomly, standard treatment group and omega-3 fish oil supplement group. ECG, myocardial enzymes, C-reactive protein, interleukin-6, changes of echocardiography and car-diac related symptoms were assessed before and after chemotherapy in two groups. Results The rate of cardiac events of chemotherapy with epirubicin was significantly higher than normal control group (30.0%vs 10.0%), there was significant differ-ence between them (P<0.05). The omega-3 fish oil supplement group, compared with the standard therapy group in the ECG changes, myocardial enzyme and C-reactive protein (CRP), interleukin -6 changes and left ventricular ejection fraction de-creased and cardiac symptoms were reduced. The changes of CRP and interleukin-6 had significant difference(P<0.05). Con-clusion Omega-3 fish oil supplement can reduce myocardial damage induced by epirubicin.