摘要
１５７例在我院住院经细胞学或病理学证实的晚期肿瘤患者，治疗中采用以阿霉素为主的联合方案化疗，阿霉素４０ｍｇ／ｍ２，静冲，每三周重复。全组病例用阿霉素前患冠心病者４０例，原有其它心电图异常者２８例，余８９例心电图正常。用阿霉素达到一定累积量时，２７例（２７／１５７）出现各种不同的心电图异常，表现为心律失常１３例、ＳＴ－Ｔ改变９例、ＱＲＳ低电压４例、传导障碍）１例，其中３例发生了充血性心力衰竭。阿霉素心脏毒性直接与其累积量有关，纵隔放疗、并用ＣＴＸ均有增加阿霉素心脏毒性的危险性，儿童、老人、冠心病以及心电图异常虽不是阿霉素禁忌症，但应慎用。适当使用维生素Ｅ、辅酶Ｑ１０等可以减少或预防阿霉素心脏毒性的发生。
patients with the terminal stage cancer, confirmed by
exami-nation of cytology and pathology, have been carried out in
combined chemotherapy withAdriamycin (ADM) as a principal agent.
40mg/m2 of ADM was given by rapid Ⅳ bolusinjection, which was
reppated every 3 weeks. The cases concern 40 persons of
coronaryheart disease 8 persons of abnormal electrocardiogram (ECG),
other 89 patients withnormal ECG. When ADM reached certain
accumulated dose, twenty-seven(17.2%) caseshad various typed of
abnormal ECG: arrhythmia in l3, ST-T change in 9, low voltageof QRS
wave in 4 and conducting block in 1. Among them, fatal congestive
heart failurewere observed in 3, the magnitude of ADM cardiotoxicity
is directly related to the inc- rease of accumulation dose of ADM.
Combined chemotherapy with cyclophamide (CTX) or chemotherapy
combined wlth mediastinal irradiation would lead to increase ADM
cardiotoxicity.Administration of ADM to children, aged,cancer
patients with coronary heart disease orwith abnormal ECG should be
suriously supervised under physicians's instruction, althoughADM for
those patients may be taken. Vitamin E or coenzyme Q10 can decrease
andprevent ADM cardiotoxicity.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
1995年第3期194-196,共3页
Chinese Journal of Cancer
