【摘要】 目的:探讨单光子断层显像(SPECT)对急性淋巴细胞白血病患儿应用柔红霉素后早期心肌毒性的诊断价值。方法:用SPECT心血池显像及超声心动图、心肌酶观察15例急性淋巴细胞白血病患儿应用柔红霉素后心功能的改变,并与对照组比较。同时收集患儿心电图、心肌肌钙蛋白Ⅰ结果进行分析。结果:15例患儿应用柔红霉素后SPECT检测结果与对照组比较示左室收缩功能降低(P<0.05),左室舒张功能、右室收缩功能无明显改变(P<0.05)。超声心动图检查结果示应用柔红霉素后心室功能与对照组比较无明显改变(P<0.05),心肌酶检查结果与对照组比较无明显改变(P<0.05)。1例患儿检测心电图、心肌肌钙蛋白I未发现异常,但SPECT已检测出其室壁运动协调性差。结论:急性淋巴细胞白血病患儿应用柔红霉素后可引起心肌损害,特别是左心室收缩功能减退。SPECT能无创、动态观察心脏功能及运动情况,较早发现心脏异常,对柔红霉素心肌毒性具有早期诊断价值,值得临床推广。更多还原

【Abstract】 Objective:To investigate the diagnostic value of single photon emission computed tomography(SPECT) in early Daunorubicin-induced cardiotoxicity in childre n with acute lymphoblastic leukemia.Methods:To observe the change of heart functi on in 15 children with acute lymphoblastic leukemia,who were treated with Dmmorubicin,we used the detection methods such as single photon emission computed tomography(SPECT) cardiac blood pool imaging and echocardiography,and the results were compared with those of the control group.At the same time,the results of the EKG,cardiac troponin I and myocardial enzyme of the children were collected and analyzed.Results:The results of SPECT showed that contractile hypofunction of left ventricle after the children with acute lymphoblastic leukemis treated with Daunorubicin(P<0.05),and the diastolic function of left ventricle,contractile function of right ventricle were not obviously changed(P<0.05).The results of the cardiography and myocardial enzyme showed no obvious change compared with those of thc control group(P<0.05).The results of the EKG,CTnI m 1 cases treated with Daunorubicin were normal,but the result detected with SPECT found out that the concordant of wall motion of ventricle was not very well.Conclusion:The children treated with Daunorubicin in acute lymphoblastic leukemia can cause myocardial damage,especially cause contractile hypofunction of ventricle SPECT can be used to detect the function and movement of the heart in dynamic state without injuring.Through SPECT we can find the abnormality of the beart and diagnose the Daunomycin-induced cardiotoxicity earlier.更多还原