恩度对非小细胞肺癌患者心脏毒性的临床研究

发布时间：2018-03-10 00:03

本文选题：重组人血管内皮抑素　切入点：心脏毒性　出处：《新疆医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：探讨恩度(重组人血管内皮抑素)对中晚期非小细胞肺癌(NSCLC)患者的心脏毒性及其相关危险因素。方法：选择188例既往无严重心血管病史、经病理组织学或细胞学确诊为中晚期失去手术机会的NSCLC化疗患者,其中92例经多西他赛+奈达铂+恩度治疗(试验组),96例经多西他赛+奈达铂治疗(对照组),两组一般临床资料差异无统计学意义(P0.05)。每一化疗周期为21天,至少完成2个周期。化疗期间监测两组患者的血压及心电图,并记录患者心血管系统症状,阳性者测定心肌酶谱和肌钙蛋白-T。结果：两组比较,化疗后试验组与对照组的心脏毒性差异有统计学意义(P0.05)。同组比较,试验组化疗前后心脏毒性差异有统计学意义(P0.05),且第1周期与第2期化疗后心电图改变差异有统计学意义(P0.05),其中8例(8.6%)患者出现了心肌酶的改变；对照组化疗前后心脏毒性差异无统计学意义(P0.05)。试验组心脏毒性反应的发生率从高到底依次为心电图改变、心血管系统症状和血压改变,经logistic回归分析表明,年龄大小、既往有无心血管病史对恩度心脏毒性的影响差异有统计学意义(均P0.05),民族、肿瘤临床分期、有无糖尿病病史对恩度心脏毒性的影响差异无统计学意义(均P0.05)。结论：恩度的心脏毒性主要表现为心电图改变、心血管系统症状和血压改变,其中心电图异常最常见,高龄、既往有心血管病史是恩度心脏毒性的危险因素。
[Abstract]:Objective: to investigate the cardiotoxicity of Endox (recombinant human vascular endostatin) in patients with advanced non-small cell lung cancer (NSCLC) and its risk factors. NSCLC chemotherapy patients who were diagnosed by histopathology or cytology as losing surgical opportunity in the middle and late stage, Among them, 92 cases were treated with docetanideplatin (trial group, 96 cases were treated with docetanideplatin) (control group, there was no significant difference in general clinical data between the two groups (P 0.05). Each chemotherapy period was 21 days. At least 2 cycles were completed. Blood pressure and electrocardiogram were monitored during chemotherapy in both groups, and cardiovascular system symptoms were recorded. Myocardial enzyme spectrum and troponin T.Results: the two groups were compared. There was significant difference in cardiac toxicity between the experimental group and the control group after chemotherapy. There were significant differences in cardiac toxicity before and after chemotherapy in the trial group (P 0.05), and there were significant differences in electrocardiogram between the first cycle and the second stage of chemotherapy. There was no significant difference in cardiac toxicity before and after chemotherapy in the control group (P 0.05). The incidence of cardiac toxicity in the experimental group was in the order of electrocardiogram changes, cardiovascular system symptoms and blood pressure changes. Logistic regression analysis showed that age was large and small. There were significant differences in the influence of cardiovascular history on the cardiac toxicity of Endor (all P 0.05, nationality, tumor clinical stage, P 0.05). There was no significant difference in the effects of diabetic history on Endor's cardiac toxicity (all P 0.05). Conclusion: the main manifestations of cardiac toxicity of Endor are electrocardiogram changes, cardiovascular system symptoms and blood pressure changes, among which abnormal ECG is the most common, and elderly. A previous history of cardiovascular disease is a risk factor for Endor's cardiac toxicity.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R734.2

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