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作为预防性治疗人环素心脏毒性的他类药物:随机对照试验的元分析
Domenico D'Amario1, Renzo Laborante2, Emiliano Bianchini2
1Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; Division of Cardiology, AOU Maggiore della Carità, Novara, Italy.
International journal of cardiology
|August 1, 2023
概括
在癌症患者中,他类药物显著降低了环素诱导的心脏毒性,并保持了左心室喷射率 (LVEF). 需要进一步的研究来证实它们对心力衰竭住院率的影响.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 人环素与5-20%的癌症患者的显著心脏毒性有关.
- 心脏毒性可以表现为心力衰竭 (HF) 和左心室喷射率 (LVEF) 降低.
- 类他类药物正在被研究,以确定它们在人环素治疗期间的心脏保护作用.
研究的目的:
- 评估在接受 antracycline 治疗的患者中,他类药物的心脏保护作用.
- 综合来自随机对照试验 (RCT) 关于在治疗中使用他类药物的证据.
主要方法:
- 在PubMed和Scopus数据库中进行了系统的搜索,截至2023年5月3日.
- 五个涉及808名患者的RCT被纳入了分析.
- 疗效终点包括心脏毒性率,心力衰竭住院和左心室喷射率 (LVEF) 变化. 还评估了诸如肌肉疼痛和不良事件等安全终点.
主要成果:
- 综合分析显示,他类药物组心脏毒性发病率显著降低 (RR0.52,P=0.01).
- 立方体使用与较高的平均LVEF (MD1.88,P<0.01) 和更有利的LVEF变化趋势 (MD2.38,P=0.05) 相关.
- 在心力衰竭住院或不良事件发生率方面没有发现显著差异.
结论:
- 类药物在减轻反环素诱导的心脏毒性和保持LVEF方面表现出有益作用.
- 对于他类药物对高频率住院率的影响,需要对更大,更强大的RCT进行进一步的研究.
- 目前的证据支持他类药物作为在接受环素治疗的患者中潜在的心脏保护策略.
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