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目的:观察磷酸肌酸钠对于儿童急性白血病蒽环类药物化疗所致的急性心脏毒性的预防及治疗作用。方法:选取72例急性白血病患儿为研究对象随机分为两组,治疗组40例,在每次蒽环类药物化疗时给予磷酸肌酸钠0.5～1 g/d静脉滴入7天;对照组的32例患儿不使用磷酸肌酸钠,待心脏毒性出现时再使用磷酸肌酸钠1～2 g/d静滴14天治疗。化疗过程中行肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白(cTn)、心电图、超声心动图检查,判断心脏损害情况。结果:治疗组急性心脏毒性发生率明显低于对照组,差异有统计学意义(P<0.05)。确诊的7例急性心脏毒性患儿经磷酸肌酸钠治疗14天后,6例治愈,1例好转,临床安全有效。结论:磷酸肌酸钠对儿童白血病蒽环类药物性心脏毒性有预防和治疗作用,值得临床推广应用。
Objective: To observe the preventive and therapeutic effects of sodium creatine phosphate on acute cardiotoxicity caused by anthracycline chemotherapy in children with acute leukemia. Methods: Seventy-two children with acute leukemia were randomly divided into two groups. Forty patients in the treatment group were given sodium phosphorylate 0.5-1 g / d intravenously for 7 days every time anthracycline chemotherapy. Thirty-two children in the group did not use creatine phosphate, and when the cardiotoxicity occurred, they were treated with 1 to 2 g / d of sodium creatine phosphate intravenously for 14 days. During chemotherapy, creatine kinase (CK-MB), cardiac troponin (cTn), electrocardiogram and echocardiography were performed to determine the cardiac damage. Results: The incidence of acute cardiotoxicity in the treatment group was significantly lower than that in the control group (P <0.05). Seven patients diagnosed with acute cardiotoxicity were treated with sodium metaphosphate for 14 days, and six patients were cured, one was improved and the patient was safe and effective. CONCLUSION: Sodium creatine phosphate can prevent and treat anthracycline cardiotoxicity in children with leukemia, which is worthy of clinical application.