磷酸肌酸钠防治儿童急性白血病蒽环类药物所致急性心脏毒性的临床观察

目的:观察磷酸肌酸钠对于儿童急性白血病蒽环类药物化疗所致的急性心脏毒性的预防及治疗作用。方法:选取72例急性白血病患儿为研究对象随机分为两组,治疗组40例,在每次蒽环类药物化疗时给予磷酸肌酸钠0.5～1 g/d静脉滴入7天;对照组的32例患儿不使用磷酸肌酸钠,待心脏毒性出现时再使用磷酸肌酸钠1～2 g/d静滴14天治疗。化疗过程中行肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白(cTn)、心电图、超声心动图检查,判断心脏损害情况。结果:治疗组急性心脏毒性发生率明显低于对照组,差异有统计学意义(P<0.05)。确诊的7例急性心脏毒性患儿经磷酸肌酸钠治疗14天后,6例治愈,1例好转,临床安全有效。结论:磷酸肌酸钠对儿童白血病蒽环类药物性心脏毒性有预防和治疗作用,值得临床推广应用。

Clinical effect of creatine phosphate sodium on acute cardiac toxcity induced by anthracycline in children with acute leukemia

Objective:To observe the clinical effect of creatine phosphate sodium on cardiac toxcity induced by anthracycline in children patients with acute leukemia. Methods:72 cases of children patients with acute leukemia were assigned into two groups randomly.Except for anthracycline-containing chemotherapy,patients in the trial goup(n=40) were additionaly treated with creatine phosphate sodium(0.5-1 g/d) for 7 days,while in the control group(n=32),patients were given creatine phosphate sodium(1-2 g/d) for 14 days when cardiac toxcity occured.Electrocardiogram,myocardial enzymes and echocardiograph during therapy and post-therapy time were examined. Results:Incidence of acute cardiac toxicity in trial group was lower than that of control group(t=5.349,P<0.05).Total 7 cases of both groups were finally diagnosed with acute cardiac toxcity,then 6 cases were cured and 1 cases was bettered after being treated with creatine phosphate sodium(1-2 g/d) for 14 days.Creatine phosphate sodium was safe and efficacy clinically. Conclusion:Creatine phosphate sodium has a good preventive and curative effect on cardiac toxcity induced by anthracycline in children patients with acute leukemia,which is worth widely application in the clinic.