右丙亚胺对蒽环类药物所致急性白血病儿童心脏毒性防治作用的临床观察

目的探讨急性白血病（AL）儿童中右丙亚胺（DZR）对蒽环类药物（ANT）所致心脏毒性的防治作用。方法观察40例急性白血病患儿，在ANT化疗时合用DZR前后临床表现和心电图、超声心动图、心肌酶谱的变化。结果ANT使用前有心电图异常者，使用ANT时合用DZR，有2例损害持续时间较长，其余均在1个月内恢复正常；ANT累积≥300mg·m^-2再进行化疗时，DZR组心电图异常发生率较对照组明显降低，与对照组比较差异有统计学意义（P〈0．01）。7例AL患儿第1次使用ANT就联合使用DZR，在其后的多次心电图等检查中未发现心脏损害，与同期患儿未使用DZR者比较，显示了良好的心脏保护作用。无一例充血性心力衰竭和其他严重心脏意外的发生。结论DZR对ANT所致急性白血病儿童心脏毒性的发生有一定的防护作用，并且对已经形成的损害有一定的修复作用。

Clinical observation of children with acute leukemia cardiotoxicity caused by anthracycline preventive effect of dexrazoxane

Objective To explore dexrazoxane（DZR） preventive effect of in children with acute leukemia（AL） cardiac toxicity caused by anthraeyclines（ANT）. Methods We observed 40 cases of acute leukemia patients treated with ANT chemotherapy in combination with dexrazoxane （DZR）. Clinical manifestations before and after the treatment, ECG, eehoeardiogram, changes of myocardial enzyme spec trum were esaluated. Results As for patient, with abnormal electrocardiogram before ANT use, when using ANT combined with DZR, there were damages of longer duration in 2 cases, the rest returned to normal within 1 month ; as for those with chemotherapy cumulative ANT I〉 300 mg ~ m-2 ,abnormal rate of ECG in DZR group was significantly lower than that in the control group ,there was statistically significant difference compared with the control group （P 〈 0.01 ）. 7 cases of children with AL used ANT combined with DZR from the beginning,without heart damage found in later times. The examination results such as ECG, compared with children without the use of DZR, showed good protective effect of heart. There was no case of congestive heart failure and other serious cardiac events. Conclusions DZR for children with acute leukemia who develop eardiac toxicity induced by ANT has certain protective effects, and has reparative effects on the damage formed.