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患者女,45岁,因发热、面色苍白、皮下瘀斑1个月于1995年11月7日入院。经血象、骨髓象和单克隆抗体检查,确诊急性淋巴细胞白血病(ALL)L_1型。首疗程VDCP方案化疗前胸片、EKG正常,B超肝脾稍大。化疗期间EKG示频发室性早搏、心肌劳损,予利多卡因、1.6—二磷酸果糖(FDP)等治疗后早搏消失。化疗结束骨髓未缓解。第二疗程VDCP方案化疗前EKG示心肌劳损,化疗期间心脏闻病理性第三心音,EKG示窦性心动过速、偶发室性早搏。治疗同上,心动过速和早搏消失。化疗结
The patient, 45 years old, was admitted to hospital on November 7, 1995 due to fever, pale, and subcutaneous ecchymosis for 1 month. The diagnosis of acute lymphoblastic leukemia (ALL) L1 type was confirmed by examination of hemograms, bone marrow smears, and monoclonal antibodies. Before the first course of VDCP chemotherapy, chest radiographs and EKG were normal, and B livers and spleens were slightly larger. During the period of chemotherapy, EKG showed premature ventricular contractions, myocardial strain, and disappeared after treatment with lidocaine and fructose 1. 6-diphosphate (FDP). End of chemotherapy did not ease bone marrow. The second course of VDCP regimen showed that EKG showed myocardial damage before chemotherapy, while the heart heard a pathological third heart sound during chemotherapy. EKG showed sinus tachycardia and occasional ventricular premature beats. Treatment above, tachycardia and premature beat disappear. Chemotherapy knot