在治疗癌症的儿童中使用 antracyclines 治疗心肌功能障碍
1Department of Pathology, University of Queensland Medical School, Australia.
Lancet (London, England)
|April 6, 1991
概括
治疗癌症的Anthracyclines的儿童显示出亚临床心肌损伤,通过运动后心声学检测到. 这种非侵入性方法在与对照组相比,在抗胰岛素幸存者中发现了心脏功能降低的增加.
科学领域:
- 心脏病学 心脏病学
- 儿科瘤学 儿科瘤学
- 心脏毒性 有关心脏的毒性.
背景情况:
- 人环素是有效的癌症化疗药物,但可能导致心脏毒性.
- 在接受 antracyclines 治疗的儿童癌症幸存者的亚临床心肌损伤需要敏感的检测方法.
- 长期监测心脏健康对于儿童癌症患者至关重要.
研究的目的:
- 通过非侵入性运动心电回声学方法,研究在接受 antracyclines 治疗的儿童中的亚临床心肌损伤.
- 为了比较在运动期间心脏功能的变化,在接受人环素的儿童与接受其他细胞毒药物的儿童中.
- 评估运动后回声心脏成像在检测早期迹象的心脏毒性.
主要方法:
- 在自行车上进行了一项非侵入性运动压力测试,持续时间长达10分钟.
- 心声扫描用于测量左心室尺寸,包括分数缩短 (FS),运动前后.
- 在整个运动测试期间,对心率和血压进行了监测.
- 参与者包括19名接受过 antracyclines 治疗的儿童和10名接受过其他细胞毒性药物治疗的儿童,所有儿童都处于缓解状态.
主要成果:
- 与对照组相比,在运动过程中,接受大环素的儿童在运动期间的分数缩短 (FS) 的增加明显较低 (3%对23%,p<0.05).
- 在调整年龄和药物暴露后,FS反应的这种差异仍然很大.
- 两组之间在运动诱导的心率或血压变化方面没有发现显著差异.
- 疾病类型没有影响测量的心脏病指数.
结论:
- 许多接受过 antracyclines 治疗的儿童可能会出现亚临床心肌损伤.
- 运动后心声图是检测这种亚临床心脏损伤的有价值的非侵入性工具.
- 长期的心脏病随访对于儿童患者来说是必不可少的,他们接受了人环素治疗,以监测潜在的心脏并发症.
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