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目的观察三氧化二砷(As2O3)对儿童急性早幼粒细胞白血病(APL)的心脏毒性。方法 11例儿童APL共进行18例次As2O3治疗,观察治疗前后心脏症状及体征、心电图、心脏彩色多普勒超声、心肌酶、心肌钙蛋白变化。结果As2O3治疗后,异常心脏症状及体征发生率为11.1%,心率加快发生率为27.8%,心电图异常发生率为44.4%,心脏多普勒超声异常发生率为11.1%,心肌钙蛋白异常发生率为5.6%。心脏毒性无性别和年龄(<10岁vs.>10岁)差异。结论常规剂量As2O3治疗儿童APL时心脏毒性较轻。
Objective To investigate the cardiotoxicity of arsenic trioxide (As2O3) in children with acute promyelocytic leukemia (APL). Methods Eleven children with APL were treated with As2O3 for 18 times. The changes of cardiac symptoms and signs, electrocardiogram, color Doppler echocardiography, myocardial enzymes and cardiac troponin before and after treatment were observed. Results After As2O3 treatment, the incidence of abnormal cardiac symptoms and signs was 11.1%, the rate of heart rate acceleration was 27.8%, the incidence of electrocardiogram abnormalities was 44.4%, the incidence of abnormal heart Doppler ultrasound was 11.1% and the incidence of abnormal cardiac calcium protein 5.6%. Cardiotoxicity was non-gender and age (<10 vs.> 10 years) differences. Conclusion The conventional dose of As2O3 is less toxic to children with APL.