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放疗和化疗(尤其是蒽环类化合物)两者常导致心血管并发症。心脏损害可分为急性或慢性。儿童期迟发性心脏损伤常导致充血性心肌病或心包炎,冠状动脉病变则罕见。作者对1960～1976年间因儿童期肿瘤而行胸部放射和(或)用CTX、ADM治疗的41例患者进行研究,患者诊断时年龄为1周～17.5岁(平均4.5岁),随访时间10.7～27.3年(平均17.3年)。患者现年龄12.8～41.5岁(平均24岁)。21例作过胸部放疗,其中13例心脏直接受照射,4例照射靠近心脏边缘部位,采用1个或2个野,不同的分割次数放射。16例加用CTX,1例并用ADM治疗。在另20例未行胸部放疗的患者中19例用CTX,4例用ADM,尚有一些采用其他化疗药物。全部病例均作标准12导联ECG、胸部X线正侧位片、超声心动图等检查。结果 ECG异常7倒(17)％。2例QRS复合波电轴右偏(例31和例36),例31尚合并右束支传导阻滞,1例房室
Both radiotherapy and chemotherapy (especially anthracyclines) often lead to cardiovascular complications. Heart damage can be classified as acute or chronic. Delayed cardiac damage in childhood often leads to congestive cardiomyopathy or pericarditis, and coronary artery disease is rare. The authors studied 41 cases of chest radiotherapy and/or CTX and ADM for childhood tumors from 1960 to 1976. The age of the patients was 1 to 17.5 years (average 4.5 years) at diagnosis, and the follow-up time was 10.7 to 27.3 years (average 17.3 years). The patient’s age was 12.8 to 41.5 years old (mean 24 years old). Twenty-one patients had thoracic radiotherapy. Among them, 13 were directly exposed to the heart, 4 were near the edge of the heart, and 1 or 2 fields were used, and the number of segments was different. 16 patients were treated with CTX, and 1 patient was treated with ADM. Of the 20 patients who had not undergone thoracic radiotherapy, 19 were treated with CTX and 4 were treated with ADM, while others used other chemotherapy drugs. All cases were used as standard 12-lead ECG, chest radiographs, echocardiography, and other tests. Results The abnormal ECG was 7(17)%. Two cases of right-biased QRS complex axis (cases 31 and 36), case 31 still combined right bundle branch block, 1 case of atrioventricular