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目的观察多西他赛、表柔比星、环磷酰胺(TEC)联合化疗对乳腺癌患者早期心脏毒性影响。方法收集2009年12月～2011年6月共71例乳腺癌患者,中位年龄48(35～64)岁,术后予6个周期TEC方案化疗,化疗前及化疗结束时、结束后12h、24h、48h及72h的分别检测血清心肌肌钙蛋白I(cTnI)及检查心电图。结果 (1)患者化疗后不同时间点cTnI出现异常的比例均较化疗前明显升高(P﹤0.01);(2)共有8(11.27%)例出现心电图改变,其中窦性心动过速4例(5.63%)、ST-T改变1例(1.41%)、窦性心动过缓2例(2.82%)、房室传导阻滞1例(1.41%),除1例为Ⅱ级毒性反应外,其余7例为Ⅰ级毒性反应。结论 TEC方案化疗后可引起早期心脏毒性反应。
Objective To observe the effects of docetaxel, epirubicin and cyclophosphamide (TEC) combined with chemotherapy on early cardiac toxicity in patients with breast cancer. Methods A total of 71 patients with breast cancer from December 2009 to June 2011 were enrolled. The median age was 48 (35 ~ 64) years old. Six months after the chemotherapy, chemotherapy was given before chemotherapy and at the end of chemotherapy. At the end of 12 hours, Serum cardiac troponin I (cTnI) was detected at 24h, 48h and 72h respectively and the electrocardiogram was examined. Results (1) The proportion of abnormal cTnI in patients at different time points after chemotherapy was significantly higher than that before chemotherapy (P <0.01). (2) A total of 8 patients (11.27%) had electrocardiogram changes, including sinus tachycardia (5.63%), 1 case of ST-T change (1.41%), 2 cases of sinus bradycardia (2.82%) and 1 case of atrioventricular block (1.41%). The remaining seven cases of grade Ⅰ toxicity. Conclusion TEC chemotherapy can cause early cardiac toxicity.