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目的：观察吡喃阿霉素（ＴＨＰ） 不同累积量时心肌酶谱、Ｈｏｌｔｅｒ 的变化及临床症状，探讨ＴＨＰ 累积量与心脏毒性的关系。方法：以ＴＨＰ５０ｍｇ／ｍ ２ 替代常用化疗方案中的阿霉素（ＡＤＭ） ，每化疗二个周期后２４ 小时查Ｈｏｌｔｅｒ 、心肌酶谱、记录临床症状。结果：ＴＨＰ 累积量７００ｍ ｇ／ ｍ２ 组的ＧＯＴ、ＬＤＨ 异常率高于６００ｍｇ／ ｍ ２ 组（ Ｐ＜ ０ ．０５） ，ＣＫ、ＣＫ－ ＭＢ 则无差异（ Ｐ ＞ ０ ．０５） 。ＴＨＰ 累积量为８００ｍ ｇ／ｍ ２ 组的预警性室性心律失常高于７００ｍ ｇ／ｍ ２ 组（ Ｐ＜ ０ ．０５） ，缺血性ＳＴ－ Ｔ 改变，两组无差异（ Ｐ ＞ ０ ．０５） 。两组心悸的发生率有差异（ Ｐ＜ ０ ．０５） ，ＴＨＰ 累积量８００ｍｇ／ｍ ２ 组高于７００ ｍｇ／ｍ２ 组。ＴＨＰ 最大累积量为１ ０００ｍｇ／ｍ ２ ，无１ 例发生心衰。结论：ＴＨＰ 的心脏蓄积毒性低于ＡＤＭ ，ＴＨＰ 的累积量以７００ ｍｇ／ ｍ２ 为宜，不宜超过８００ｍｇ／ｍ ２ 。
OBJECTIVE: To observe changes in myocardial zymogram, Holter, and clinical symptoms of different doses of pirarubicin (THP), and to investigate the relationship between THP accumulation and cardiotoxicity. METHODS: Doxorubicin (ADM) in common chemotherapy regimens was replaced with THP 50 mg/m 2 , Holter, myocardial enzymes, and clinical symptoms were recorded 24 hours after each cycle of chemotherapy. RESULTS: The abnormal rate of GOT and LDH in the 700m g/m2 THP group was higher than that in the 600mg/m2 group (P<0.05), but there was no difference between the CK and CK-MB groups (P > 0.05). Predictive ventricular arrhythmia in the 800m g/m 2 group was higher than the 700m g/m 2 group (P<0.05), and there was no difference in ischemic ST-T between the two groups (P > 0). 05). There was a difference in the incidence of palpitations between the two groups (P 0. 05), and the cumulative amount of THP 800 mg/m 2 was higher than that of the 700 mg/m 2 group. The maximum cumulative amount of THP was 1 000 mg/m 2 , and no heart failure occurred in 1 patient. Conclusion: THP has lower cardiac accumulation toxicity than ADM. The cumulative amount of THP is preferably 700 mg/m2 and should not exceed 800 mg/m2.