持续静脉缓慢滴注和静脉推注降低蒽环类药物心脏毒性风险的荟萃分析

发布时间：2018-12-31 08:36

【摘要】：目的:比较持续静脉缓慢滴注和静脉推注蒽环类药物心脏毒性的发生风险。方法:系统检索Cochrane图书馆、Elsevier、PubMed、Embase、CNKI、万方等数据库,纳入国内外已公开发表的有关比较持续静脉缓慢滴注和静脉推注蒽环类药物治疗肿瘤患者后心脏毒性发生风险的研究。检索截止日期为2016年5月,采用RevMan 5.3软件对数据进行荟萃分析,计算合并后的相对危险度(RR)及其95%可信区间(CI)。结果:共纳入11篇文献,包括967例患者,所有患者蒽环类药物治疗前均无心脏病史。荟萃分析显示:与持续静脉缓慢滴注相比,静脉推注蒽环类药物患者心脏毒性总体发生风险增加(RR=1.26,95%CI:1.06~1.51,P=0.01);亚组分析发现,成人肿瘤患者中,静脉推注蒽环类药物患者的心脏毒性发生风险是持续静脉缓慢滴注蒽环类药物患者的2.06倍(RR=2.06,95%CI:1.41~3.02;P0.001),而在儿童肿瘤患者中,持续静脉缓慢滴注和静脉推注蒽环类药物相比,心脏毒性发生风险无统计学差异(RR=1.01,95%CI:0.83~1.23,P=0.93)。结论:与静脉推注相比,持续静脉缓慢滴注蒽环类药物可降低成人肿瘤患者心脏毒性发生风险,却不能降低儿童肿瘤患者心脏毒性的发生风险。
[Abstract]:Objective: to compare the risk of cardiac toxicity between sustained intravenous infusion and intravenous injection of anthracyclines. Methods: Cochrane library, Elsevier,PubMed,Embase,CNKI, Wanfang database were searched systematically. To study the risk of cardiac toxicity in patients with tumor treated by continuous intravenous instillation and intravenous injection of anthracycline drugs, which have been published at home and abroad. The deadline for retrieval is May 2016. The meta-analysis of the data is carried out using RevMan 5.3 software, and the combined relative risk (RR) and its 95% confidence interval (CI). Are calculated. Results: 11 articles were included, including 967 patients, all of whom had no history of heart disease before treatment with anthracycline. Meta-analysis showed that the overall risk of cardiac toxicity (RR=1.26,95%CI:1.06~1.51,P=0.01) was increased in patients with anthracycline intravenous injection compared with slow intravenous infusion. Subgroup analysis showed that the risk of cardiac toxicity in adult patients with tumor was 2.06 times higher than that in patients with chronic intravenous infusion of anthracyclines (RR=2.06,95%CI:1.41~3.02;). There was no significant difference in the risk of cardiac toxicity (RR=1.01,95%CI:0.83~1.23,P=0.93) in children with tumor patients by slow intravenous infusion and intravenous injection of anthracyclines. Conclusion: compared with intravenous injection, slow intravenous infusion of anthracycline can reduce the risk of cardiac toxicity in adult tumor patients, but it can not reduce the risk of cardiac toxicity in children with tumor.
【作者单位】：南昌大学第二附属医院心内科;江西省分子医学重点实验室;
【基金】：国家自然科学基金重点项目(No:8153000545)
【分类号】：R969

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