Effect of Dextroimide Combined with Levocarnitine on the Prevention of Cardiac Toxicity Induced by Epirubicin Chemotherapy in Patients with Hepatocellular Carcinoma
SU Yan
Yantai Affiliated Hospital of Binzhou Medical College, Shandong Yantai 264100
Abstract:【Objective】 To study the efficacy and safety of dextroimide combined with levocarnitine for epirubicin-induced cardiotoxicity in patients with hepatocellular carcinoma. 【Methods】 A total of 86 patients with liver cancer received epirubicin chemotherapy in our hospital were selected as study subjects. The patients were randomly divided into two groups with 43 cases in each group. The patients in both groups were treated with epirubicin after admission. One day before chemotherapy, patients in the control group received dexamine injection, while patients in the observation group received both dextromine and levocarnitine. Patients in both groups were routinely given 5 cycles of adjuvant chemotherapy, with 3 weeks as a cycle. The changes of electrocardiogram (sinus tachycardia, premature beat, QRS low voltage, ST-T change, Q-T interval prolongation, atrioventricular block) and myocardial enzyme spectrum markers (LDH,cTnI,CK and CK-MB) were observed. The therapeutic effect and the incidence of non-cardiac toxicity were compared between the two groups as well. 【Results】 ①After treatment, the incidence of abnormal ECG in the two groups increased with the increase of the number of chemotherapy cycles. The incidence of abnormal ECG in the control group after treatment was higher than that before treatment (P<0.05). The incidence of abnormal electrocardiogram in the observation group was higher than that before treatment, however, the difference was not statistically significant (P<0.05). ②The level of myocardial enzyme spectrum in the observation group was not significantly increased after treatment, while the myocardial enzyme level of the control group after treatment was higher than that before treatment; and the difference was significant compared with that of the observation group (P<0.05). ③There was no statistically significant in the incidence of non-cardiac toxicity in both groups during the treatment (P>0.05). 【Conclusion】 Dextroimide combined with levocarnitine has a better protective effect on the occurrence of cardiac toxicity induced by epirubicin than single application of dextroimide.
苏妍. 右丙亚胺联合左卡尼汀预防表柔比星化疗致肝癌患者心脏毒性的效果[J]. 医学临床研究, 2020, 37(8): 1139-1141.
SU Yan. Effect of Dextroimide Combined with Levocarnitine on the Prevention of Cardiac Toxicity Induced by Epirubicin Chemotherapy in Patients with Hepatocellular Carcinoma. JOURNAL OF CLINICAL RESEARCH, 2020, 37(8): 1139-1141.
[1] 王咏梅,徐蕾,王革芳,等.左卡尼汀对老年肝脏恶性肿瘤动脉灌注化疗中的心脏保护作用[J].临床与基础研究,2011,16(8):319-320. [2] 张守文,张小霞,石增成,等.卡维地洛联合曲美他嗪对接受含蒽环类药物化疗乳腺癌患者的心脏保护作用[J].中国全科医学,2016,19(7) :794-798. [3] Kaw asaki N, Lee JD, Sh imizu H, et al.Cardiac energy m etabolism at several stages of adriamycin induced heart failure in rats[J].Int J Cardiol,2016, 55:217-225. [4] 王璇.右丙亚胺联合参麦注射液对治疗急性白血病患者化疗期间心脏毒性的研究[J].中国民康医学,2015(12):86-88. [5] 刘良,刘兆喆,刘永叶,等.小剂量卡维地洛联合坎地沙坦在乳腺癌辅助化疗中预防蒽环类化疗药物心脏毒性的作用[J].中华肿瘤杂志,2013,35(12) : 936-940. [6] 冯保华,王俊生,李保中,等.右丙亚胺对表阿霉素辅助化疗时的心脏保护作用及其机制分析[J].现代肿瘤医学,2017,25(23):3776-3779. [7] 张楚婕,程蕾蕾.蒽环类药物致心脏毒性的预防与治疗现状[J].中国临床医学,2016,23(1):110-113. [8] 栾霞,张星霖,杨庆辉.左卡尼汀对阿霉素心脏毒性的保护作用[J].中国慢性病预防与控制,2006,14(4):268-269. [9] 高向阳 ,韩正祥,杜秀平.右丙亚胺对表柔比星所致心脏毒性防治作用的观察[J].中华肿瘤防治杂志 ,2010,17(4):296-298.