表阿霉素对心脏影响的临床观察

目的探讨表阿霉素对心脏的不良反应。方法观察应用表阿霉素后1个月内就诊的42例患者的症状、24h动态心电图、心肌肌钙蛋白I(cTnI)的改变。结果表阿霉素累积剂量:男性为(353±15)mg/m2,女性为(345±12)mg/m2,两者比较差异无统计学意义(P>0.05)。表阿霉素不良反应的主要症状为胸痛37例(88.1%),心悸34例(80.8%)。24h动态心电图显示窦性心动过速40例(45.2%),ST-T改变35例(83.3%),室内传导阻滞32例(76.2%),房性早搏23例(54.8%),室性早搏20例(47.6%),短时阵发性房性心动过速15例(35.7%)。用药前男、女性患者cTnI水平分别为(0.32±0.41)mg/L和(0.33±0.40)mg/L,用药后分别为(5.37±1.35)mg/L和(11.88±1.54)mg/L,用药后较用药前有明显升高(P<0.05),且女性患者血清浓度更高(P<0.05)。结论应用低于引起心脏毒性剂量的表阿霉素仍可引起心脏的毒性反应,cTnI可用于检测心脏的受损情况。

Clinical observation of the effect of 4'-epi-doxorubicin on he art

Objective To investigate the potential adverse effects of 4＇-epi-doxontbicin （EPI） on heart. Methods The changes of symptoms, 24h dynamic ECG, cardiac troponin I （cTnI） in 42 patients with heart diseases were observed one month after treatment with EPI. Results There was no significant difference in the cumulated dose of EPI between male and female male： （353 ± 15）mg/m^2 vs female： （345 ± 12）mg/m^2, P 〉 0.05）] .The main adverse reactions of EPI were chest pain 37 cases（ 88.1% ）, palpitation 34 cases（80.8 % ）, sinus tachycardia showed by 24h dynamic, ECG in 40 cases（45.2 % ）, the changes of ST-T in 35 cases（ 83.3 % ）, intraventricular conduction block in 32 cases（76.2% ）, atrial premature beat in 23 cases（54.8% ）, ventricular premature beat in 20 cases（47.6% ）, transient paroxysmal tachycardia in 15 cases （35.7%）. The levels of cTnI before treatment in male and female were （0.32 ± 0.41）mg/L and （0.33± 0.40）mg/L respectively,however, which were （5.37± 1.35）mg/L and （11.88± 1.54）mg/L after treatment,there was a significant difference before and after treatment （ P 〈 0.05）.The levels of cTnI in women were significantly higher than those in men. Conclusion The lower close of EPI can cause toxic reaction of heart, and cTnI can be used to monitor the state of cardiac damage.