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阿霉素(adriamycin简称 ADR)是蒽环类抗肿瘤药物。该药抗肿瘤谱广,疗效显著,1970年用于临床治疗肿瘤以来,被认为是治疗实体肿瘤最有效的药物。但是,1973年Lefrak首次报告了阿霉素心脏毒性,认为它比骨髓抑制作用,消化道和肾脏毒性等更为危险,由于心脏毒性而限制了应用。目前认为心脏毒性的主要临床表现为心电图变化和充血性心衰。当阿霉素总剂量>550 mg/m~2时,30％患者发生剂量依赖性心肌病。部分病人因此而死亡。实践研究证明,阿霉素心脏毒性的个体差异很大。Amars报道,有的患者可耐受 5000 mg/m~2不发生心功能障碍,有些患者接受40mg/m~2就会发生致命的充血心衰。本文将近年国内外对阿霉素引起心脏毒性的理论探讨综述如下。
Adriamycin (ADR) is an anthracycline anti-tumor drug. The drug anti-tumor spectrum is broad, the effect is significant, since 1970 for the clinical treatment of tumors, is considered to be the most effective drug treatment of solid tumors. However, Lefrak first reported cardiotoxicity in adriamycin in 1973, arguing that it is more dangerous than myelosuppression, gastrointestinal and nephrotoxicity and is limited in its application due to cardiotoxicity. Cardiac toxicity is currently considered the main clinical manifestations of ECG changes and congestive heart failure. When doxorubicin total dose> 550 mg / m ~ 2, 30% of patients with dose-dependent cardiomyopathy. Some patients died as a result. Practical studies have shown that adriamycin cardiotoxicity vary widely among individuals. Amars reports that some patients tolerate cardiac dysfunction at 5000 mg / m 2 and that some patients receive fatal congestive heart failure at 40 mg / m 2. In this paper, the theory of doxycycline-induced cardiotoxicity in recent years at home and abroad are summarized as follows.