Ostański M, Sońta-Jakimczyk D
Katedry i Kliniki Hematologii Dzieciecej i Chemioterapii w Zabrzu.
Wiad Lek. 2001;54(11-12):650-5.
The purpose of the presented study was to define the exercise tolerance in patients after acute lymphoblastic leukemia (ALL) treatment in childhood. Three groups of persons were examined: group A: 20 children, aged 7-19 years (mean 12.4 y), examined immediately after ALL therapy completion, with cumulative anthracycline (ATC) doses administered 155.8-300 mg/m2 and dexrazoxane, as cardioprotectant, group B: 36 patients, aged 12-24 years (mean 15.9), being 3-5 years after ALL treatment, who received ATC in cumulative doses 148.6-416.7 mg/m2, without cardioprotection, group C: 28 healthy volunteers, aged 9-25 years (mean 17.3), as controls. All the examined patients belonged to NYHA functional class I. In all subjects the exercise treadmill test was performed according to modified Bruce protocol. The parameters analysed were: MET--number of metabolic effort units achieved at the test, HRmax--maximal heart rate during exercise, %HRmax--percent of maximal HR for given patient's age achieved during the STdep--depression of ST segment in electrocardiography (ECG) immediately after the maximal exercise. During the exercise members of all 3 groups achieved the required HRmax without serious complaints and ECG abnormalities. Examined persons in group A,B and C presented with effort levels (MET), %HRmax, STdep that did not differ significantly. Only HRmax in groups A and C were higher than that achieved by members of group B.
本研究的目的是确定儿童急性淋巴细胞白血病(ALL)治疗后患者的运动耐力。对三组人员进行了检查:A组:20名儿童,年龄7 - 19岁(平均12.4岁),在ALL治疗完成后立即接受检查,蒽环类药物累积剂量(ATC)为155.8 - 300mg/m²,并使用右丙亚胺作为心脏保护剂;B组:36名患者,年龄12 - 24岁(平均15.9岁),在ALL治疗后3 - 5年,接受的ATC累积剂量为148.6 - 416.7mg/m²,未进行心脏保护;C组:28名健康志愿者,年龄9 - 25岁(平均17.3岁),作为对照组。所有接受检查的患者均属于纽约心脏协会(NYHA)心功能I级。对所有受试者均按照改良的布鲁斯方案进行运动平板试验。分析的参数包括:代谢当量(MET)——试验中达到的代谢努力单位数、最大心率(HRmax)——运动期间的最大心率、最大心率百分比(%HRmax)——给定患者年龄在最大运动后心电图(ECG)中ST段压低(STdep)时达到的最大心率百分比。在运动过程中,三组所有成员均达到了所需的HRmax,且无严重不适和ECG异常。A、B、C组受检者的运动水平(MET)、%HRmax、STdep无显著差异。只有A组和C组的HRmax高于B组成员所达到的水平。