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目的探讨右丙亚胺对柔红霉素所致心脏毒性的防治作用。方法观察10例急性非淋巴细胞白血病患者,在接受含柔红霉素化疗时合用右丙亚胺后心电图及左室射血分数(EF)的变化。并与未使用右丙亚胺的对照组12例作比较。结果在柔红霉素方案化疗1个疗程后,右丙亚胺组与对照组心电图异常发生率分别为10.0%(1/10)和25.0%(3/12),左室EF下降超过10%的发生率分别为10%(1/10)和16.7%(2/12),两者差异均无统计学意义。3个疗程后,右丙亚胺组与对照组心电图异常发生率分别为20.0%(2/10)和50.0%(6/12),左室EF分数下降超过10%的发生率分别为20.0%(2/10)和41.7%(5/12)(P<0.01)。对产生心脏毒性的8例患者,在其后再次接受含柔红霉素方案化疗时联合使用右丙亚胺,2个疗程结束后有5例患者异常心电图转为正常,4例患者EF分数得到恢复,无一例心脏损害加重。结论右丙亚胺对柔红霉素所致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。
Objective To investigate the preventive and therapeutic effects of dexrazoxane on daunomycin induced cardiotoxicity. Methods The changes of electrocardiogram and left ventricular ejection fraction (EF) in 10 patients with acute non-lymphocytic leukemia undergoing daunorubicin combined with dexrazoxane were observed. And compared with the control group without using dexrazoxane in 12 cases. Results After 1 course of daunorubicin regimen chemotherapy, the incidences of abnormal electrocardiogram in dexrazoxane group and control group were 10.0% (1/10) and 25.0% (3/12) respectively, and the left ventricular EF decreased by more than 10% The incidence rates were 10% (1/10) and 16.7% (2/12), respectively, with no significant difference between the two groups. After three courses of treatment, the incidences of ECG abnormalities in dexrazoxane group and control group were 20.0% (2/10) and 50.0% (6/12), respectively. The incidences of left ventricular EF decreased by more than 10% were 20.0% (2/10) and 41.7% (5/12) (P <0.01). Of the 8 patients who developed cardiotoxicity, dexrazoxane plus dexmedetomil was administered again thereafter, and five patients had normal ECG abnormalities after two courses of treatment, and EF scores of four patients were obtained Recovery, no case of heart damage worse. Conclusion Dex not only protected against daunomycin-induced cardiotoxicity, but also restored the damaged lesions.