柔红霉素治疗儿童白血病的心脏毒性:附13例临床报告

为探讨柔红霉素治疗儿童白血病的心脏毒性,总结了102例接受柔红霉素治疗的急性白血病患儿的临床资料,分析有心脏毒性患儿的临床特点,心电图,超声心动图变化,并对患儿进行跟踪随访。结果发现,102例接受柔红霉素治疗患儿中有13例发生心脏毒性,表现为充血性心力衰竭,扩张性心肌病和各种心律失常。表明年龄越小,柔红霉素累积量越大,生存期越长,心脏毒性发生率越高。柔红霉素所致心脏毒性为不可逆性。

Clinical report on the daunomycin(DNR)-related cardiotoxicity in the treatment of childhood leukemia attached with 13 cases

With the great improvement in the treatment of childhood leukemia,the quality of life has become a pivotal issue.Daunomycin-related cardiotoxicity is the main obstacle to obtain such target.In order to raise vigilance and reduce the incidence of daunomycin-related cardiotoxicity,the clinical patterns of such toxicity and the safety threshold of the daunomycin dosage were presented.Clinical data were reviewed in 102 children with leukemia who received DNR-based chemotherapy protocols.The clinical manifestations EKG and UCG in 13 children who had DNR-related toxicity were analyzed retrospectively and followed up of them,two had congestive heart failure,one had dilated cardiomyopathy and others had different type of arrhythmic or abnormal EKG.These results suggested that the incidence of DNR-related cardiotoxicity was higher in young children.The younger the age ,the higher the incidence,the higher the dosage of DNR piled up,the higher the incidence of DNR-related cardiotoxicity,and this DNR-related cardiotoxicity is irreversible.Much attention should be paid to the DNR-dose related cardiotoxicity when the DNR-based chemotherapy protocols were given to treat children with leukemia.