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【目的】探讨右丙亚胺联合左卡尼汀用于表柔比星致肝癌患者心脏毒性的疗效及安全性。【方法】在本院接受表柔比星化疗的86例肝癌患者随机分为两组，各43例。两组患者入院后均给予表柔比星化疗，在化疗前一天，对照组给予右丙亚胺注射液治疗，观察组给予右丙亚胺和左卡尼汀治疗，两组患者均常规给予5个周期的辅助化疗，3周为1个周期。观察两组心电图指标（窦速、早搏、QRS低电压、ST-T改变、Q-T间期延长、房室传导阻滞）以及心肌酶谱标志物的变化。比较两组疗效及治疗期间非心脏毒性不良反应发生率。【结果】①治疗后两组心电图异常发生率随着化疗周期数的增加而上升，对照组治疗后心电图异常发生率均高于治疗前（P0.05），但明显低于对照组（P0.05），对照组较治疗前升高（P<0.05）,且明显高于观察组（P0.05）。【结论】右丙亚胺联合左卡尼汀较单一应用右丙亚胺对表柔比星所致心脏毒性的发生具有更好的防护作用，且安全性较好。|%n【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 (P0.05). 【Conclusion】Dextroimide combined with levocarnitine has a better protective effect on the occurrence of cardiac toxicity induced by epirubicin than single application of dextroimide.n