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营养状况和儿童早期心脏毒性
Radnyi Mande1, Maya Prasad2,3, Rajul Gala1
1Division of Pediatric Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
BMJ supportive & palliative care
|December 18, 2025
概括
接受 antracycline 治疗的威尔姆斯瘤和肝细胞瘤儿童面临11.7%的早期心脏毒性风险,营养不良是其中一个重要因素. 早期的营养评估和心脏监测对这个易受伤害的群体至关重要.
科学领域:
- 儿科瘤学 儿科瘤学
- 心脏病学 心脏病学
- 营养科学 营养科学
背景情况:
- 抗环素化疗对于治疗儿童癌症如威尔姆斯瘤 (WT) 和肝细胞母细胞瘤至关重要.
- 在接受癌症治疗的儿童中,心脏毒性是一个严重的问题.
- 营养不良对这些儿科患者心脏毒性的影响需要进一步调查.
研究的目的:
- 确定WT和肝细胞瘤儿童早期心脏毒性的发生率,模式和危险因素.
- 评估营养不良对心脏毒性发展的具体影响.
- 评估当前监测和管理策略的有效性.
主要方法:
- 在2017年至2022年期间接受治疗的137名儿童的回顾性队列研究.
- 序列回声心脏学用于心脏功能监测.
- 世界卫生组织 (WHO) 和AHOPCA标准用于营养状况评估.
- 多变量逻辑回归分析以确定心脏功能障碍的风险因素.
主要成果:
- 早期心脏毒性的发生率为11.7%,大多数病例无症状.
- 根据世卫组织和AHOPCA的标准,营养不良是普遍存在的,并且与心脏功能障碍有显著联系.
- 大多数受影响的儿童在医疗干预后恢复.
结论:
- 营养不良的儿童接受WT和肝母细胞瘤的环素治疗,患早期心脏毒性风险更高.
- 建议进行常规的营养评估和早期干预.
- 密切的心脏监测对于减轻这种高风险儿科患者群体的急性心脏毒性至关重要.
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