摘要
目的 探讨四硫化四砷 (As4S4)对急性早幼粒细胞白血病 (APL)患者心电图校正后QT(QTc)间期的影响。方法 复方柏子仁 (主要成分As4S4)治疗的 90例患者分为诱导缓解组和巩固维持治疗组。诱导缓解组测定并记录患者服药前及缓解后的血砷浓度及同步 12导联心电图 ;巩固维持治疗组测定并记录患者服药前及第 2 ,4 ,6 ,8,10疗程后的血砷浓度及心电图。测量每份心电图的QT间期值 ,以Bazett公式校正 ,计算出QTc,观察血砷浓度与QTc间期的关系。结果 无论诱导缓解组还是巩固维持治疗组 ,口服As4S4均能引起QTc间期的延长 ,QTc与As4S4的剂量及血砷浓度有关 ,随着As4S4的累积剂量或血砷浓度增大 ,QTc值及其延长的幅度也增大。在巩固维持治疗组服药的 10个疗程中 ,QTc值异常 (≥ 4 4 0ms)率平均为 37.7% ,随服用As4S4累积剂量的增加 ,各疗程血砷浓度缓慢上升 ,但各疗程之间的变化差异无显著性 (P >0 .0 5 )。各疗程中QTc间期虽逐步延长 ,但QTc值异常率在各疗程中无显著性差异 (P >0 .0 5 )。QTc异常的患者均无临床症状 ,未出现室性心动过速或尖端扭转型室性心动过速等病变 ,无一例患者因QTc间期延长而终止治疗。结论 As4S4治疗APL虽可引起QTc间期延长 ,且QTc间期的变化与血砷浓度呈正相关 。
Objective To evaluate the effect of tetra-arsenic tetra-sulfide (As 4 S 4 ) therapy on the corrected QT interval (QTc) in the acute promyelocytic leukemia(APL) patients. Methods Ninety cases of APL treated with As 4 S 4 were devided into two groups -the remission induction group and maintenance therapy group. Blood arsenic concentration was measured and a 12-lead electrocardiogram (ECG) was simultaneously performed before treatment and after remission in the induction group, and before and 2,4,6,8,10 courses after the treatment in the maintenance therapy group. QT interval on each ECG was measured and corrected by the Bazett formula. Results Oral administration of As 4 S 4 could lead to the prolongation of QTc both in remission induction and maintenance therapy groups. QTc prolongation was related to the doses of As 4 S 4 and blood arsenic levels. QTc prolongation and its variation range were increased with accumulative doses of As 4 S 4 and the blood arsenic levels. In ten courses maintenance therapy patients, the average abnormal rate of QTc was 37.7%. Blood arsenic concentration was increased slowly with courses, but the variation had no statistical difference (P>0.05). All the patients whose QTc was abnormal (≥440 ms) had neither symptoms nor serious cardiac events, such as ventricular tachycardia and Torsade de pointes and could complete the As 4S 4 therapy.Conclusion Although As 4 S 4 thrapy can lead to QTc prolongation in the treatment of APL patients, it does not preclud the completion of the thrapy.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2004年第6期359-361,共3页
Chinese Journal of Hematology
基金
教育部高等学校骨干教师基金资助项目
