黄芪多糖防治蒽环类药物心脏毒性的临床观察(1)
[摘要] 目的 探討黄芪多糖防治蒽环类药物心脏毒性的临床效果。 方法 选取2013年9月～2016年3月广州医科大学附属肿瘤医院确诊治疗的乳腺癌或恶性淋巴瘤患者80例，依据随机数表法将其随机分为防治组和常规组，每组40例。常规组患者给予常规治蒽环类药物[乳腺癌：环磷酰胺(CTX)+表阿霉素(EPI)/吡柔比星(THP)+氟尿嘧啶(5-FU)，恶性淋巴瘤：CTX+EPI/THP+长春地辛(VDS)+泼尼松]和1.0 g磷酸肌酸钠+100 mL生理盐水的静脉滴注治疗，防治组患者在此基础上加用250 mg黄芪多糖+500 mL生理盐水的静脉滴注治疗。采用酶联免疫吸附法(ELISA)检测血浆B型脑钠肽(BNP)、一氧化氮(NO)水平、血小板α-颗粒膜蛋白(GMP-140)，通过常规心电图检测左心室射血分数(LVEF)，采用Kamofsky评分法(KPS)评估生活质量，随访6个月。 结果 防治组和常规组患者治疗有效率比较，差异无统计学意义(P > 0.05)；防治组患者血浆BNP、GMP-140水平明显低于常规组，血浆NO和LVEF水平明显高于常规组，差异有统计学意义(P < 0.05)；防治组患者治疗后3、6个月KPS评分明显高于常规组，差异有统计学意义(P < 0.05)。 结论 黄芪多糖治疗可有效减少蒽环类药物治疗患者的心脏毒性，有利于提高患者的生活质量，且对治疗效果无不良影响。
[关键词] 黄芪多糖；蒽环类药物；心脏毒性；生活质量；疗效
[中图分类号] R969.4 [文献标识码] A [文章编号] 1673-7210(2017)07(b)-0136-04
Clinical observation of astragalus polysaccharide in preventing the cardiotoxicity of anthracyclines
KONG Jiaxin1 SU Xuchun1 DAI Shilei1 DENG Yuemin2 CHENG Ling1 SONG Jing1
1.Department of Integrated Chinese and Western Medicine， Cancer Center of Guangzhou Medical University， Guangdong Province， Guangzhou 510095， China； 2.Department of Clinical Laboratory， Cancer Center of Guangzhou Medical University， Guangdong Province， Guangzhou 510095， China
[Abstract] Objective To discuss the clinical effect of astragalus polysaccharide in preventing the cardiotoxicity of anthracyclines. Methods Eighty patients diagnosed as breast cancer or malignant lymphoma in Cancer Center of Guangzhou Medical University from September 2013 to March 2016 were selected and randomly divided into prevention group and conventional group according to random number table method， with 40 cases in each group. The conventional group was given regular anthracyclines drugs [breast cancer： Cyclophosphamide (CTX) + Epirubicin (EPI) / Theprubicin (THP) + Fluorouracil (5-FU)， malignant lymphoma： CTX+EPI/THP， Vindesine (VDS)+Prednisone] and 1.0 g sodium phosphocreatine+100 mL normal saline， intravenous drip， on basis of which， the prevention group was added with 250 mg astragalus polysaccharides+500 mL normal saline， intravenous drip. The levels of plasma B-type brain natriuretic peptide (BNP)， nitric oxide (NO)， platelet alpha granule membrane protein (GMP-140) were detected by enzyme-linked immunosorbent assay (ELISA). The left ventricular ejection fraction (LVEF) was detected by ECG. The quality of life was assessed by Kamofsky performance status (KPS)， followed up for 6 months. Results The effective rate between prevention group and conventional group had no statistically significant difference (P > 0.05). The levels of plasma BNP， GMP-140 in prevention group were significantly lower than those of conventional group， the levels of plasma NO and LVEF were higher than those of conventional group， the differences were statistically significant (P < 0.05). The KPS scores of prevention group after treatment for 3， 6 months were significantly higher than those of conventional group， the differences were statistically significant (P < 0.05). Conclusion Astragalus polysaccharides can effectively reduce the cardiac toxicity induced by anthracycline， which is helpful to improve the quality of life， and it has no side effects on the curative effect., 百拇医药(孔嘉欣 苏旭春 戴诗蕾 邓粤敏 程玲 宋璟)
[关键词] 黄芪多糖；蒽环类药物；心脏毒性；生活质量；疗效
[中图分类号] R969.4 [文献标识码] A [文章编号] 1673-7210(2017)07(b)-0136-04
Clinical observation of astragalus polysaccharide in preventing the cardiotoxicity of anthracyclines
KONG Jiaxin1 SU Xuchun1 DAI Shilei1 DENG Yuemin2 CHENG Ling1 SONG Jing1
1.Department of Integrated Chinese and Western Medicine， Cancer Center of Guangzhou Medical University， Guangdong Province， Guangzhou 510095， China； 2.Department of Clinical Laboratory， Cancer Center of Guangzhou Medical University， Guangdong Province， Guangzhou 510095， China
[Abstract] Objective To discuss the clinical effect of astragalus polysaccharide in preventing the cardiotoxicity of anthracyclines. Methods Eighty patients diagnosed as breast cancer or malignant lymphoma in Cancer Center of Guangzhou Medical University from September 2013 to March 2016 were selected and randomly divided into prevention group and conventional group according to random number table method， with 40 cases in each group. The conventional group was given regular anthracyclines drugs [breast cancer： Cyclophosphamide (CTX) + Epirubicin (EPI) / Theprubicin (THP) + Fluorouracil (5-FU)， malignant lymphoma： CTX+EPI/THP， Vindesine (VDS)+Prednisone] and 1.0 g sodium phosphocreatine+100 mL normal saline， intravenous drip， on basis of which， the prevention group was added with 250 mg astragalus polysaccharides+500 mL normal saline， intravenous drip. The levels of plasma B-type brain natriuretic peptide (BNP)， nitric oxide (NO)， platelet alpha granule membrane protein (GMP-140) were detected by enzyme-linked immunosorbent assay (ELISA). The left ventricular ejection fraction (LVEF) was detected by ECG. The quality of life was assessed by Kamofsky performance status (KPS)， followed up for 6 months. Results The effective rate between prevention group and conventional group had no statistically significant difference (P > 0.05). The levels of plasma BNP， GMP-140 in prevention group were significantly lower than those of conventional group， the levels of plasma NO and LVEF were higher than those of conventional group， the differences were statistically significant (P < 0.05). The KPS scores of prevention group after treatment for 3， 6 months were significantly higher than those of conventional group， the differences were statistically significant (P < 0.05). Conclusion Astragalus polysaccharides can effectively reduce the cardiac toxicity induced by anthracycline， which is helpful to improve the quality of life， and it has no side effects on the curative effect., 百拇医药(孔嘉欣 苏旭春 戴诗蕾 邓粤敏 程玲 宋璟)