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目的 指导临床使用蒽环类药，减少药物毒性所致心功能损害。方法 超声心动图、心电图、心肌酶谱及胸部Ｘ线片，检测白血病、淋巴瘤患儿化疗前后的心功能状态。结果 ８５ 例患儿１３１ 次超声心动图测定，异常率３８ ．８２％ ，化疗前异常率２０ ．９３ ％（９／４３） ， 化疗后异常率５０ ％（２１／４２） ， 蒽环类药累积计量≥３５０ ｍｇ／Ｍ２ 者，异常率明显增高。２ 例死于心肌病者药物累积量为１００ ｍｇ／Ｍ２ 和４５４ ．３５ ｍｇ／Ｍ２ 。结论 对白血病、淋巴瘤患儿作化疗前后心功能监测十分必要，临床应根据蒽环类药物累积总量及心功能状态调整化疗用药；超声心动图监测心功能敏感且实用。
Objective To guide the clinical use of anthracyclines to reduce cardiac toxicity caused by drug damage. Methods Echocardiography, electrocardiogram, myocardial enzymes and chest X-ray were used to detect the cardiac function before and after chemotherapy in children with leukemia and lymphoma. Results 85 cases of children with 131 echocardiographic determination, the abnormal rate of 38. 82%, anomaly rate before chemotherapy 20. 93% (9/43), abnormal rate after chemotherapy 50% (21/42), Anthracycline cumulative measurement ≥ 350 mg / M2, the abnormal rate was significantly higher. Two patients died of cardiomyopathy drug cumulative amount of 100 mg / M2 and 454. 35 mg / M2. Conclusion It is necessary to monitor the cardiac function in children with leukemia and lymphoma before and after chemotherapy. The clinical application of chemotherapy should be adjusted according to the total amount of anthracycline and cardiac function. The echocardiography is sensitive and practical in monitoring cardiac function.