Luján Juan, García De Burgos Fernando, Jordán Alejandro, García Miguel, Reyes Fernando, Espinosa María D
Sección de Cardiología, Servicio de Medicina Interna, Hospital General Universitario de Elche, Alicante, Spain.
Rev Esp Cardiol. 2002 Jul;55(7):764-7. doi: 10.1016/s0300-8932(02)76696-7.
Treatment with 5-fluorouracil is common in oncological patients. Side effects on bone marrow, skin, and mucous membranes have been reported. Cardiotoxicity, which is less predictable, can be life-threatening. Manifestations include angina, arrhythmias, infarction, heart failure and cardiogenic shock. The toxic mechanisms that might be involved have been much discussed but have not yet been clearly established. Current evidence supports the possibility of a metabolic effect in common with the cascade secondary to ischemia due to coronary disease. Based on a case report, we discuss the usual clinical presentation, treatment and prognosis. Finally we make recommendations for managing patients being treated with 5-fluorouracil.
5-氟尿嘧啶治疗在肿瘤患者中很常见。已有报道其对骨髓、皮肤和黏膜有副作用。心脏毒性较难预测,可能危及生命。表现包括心绞痛、心律失常、梗死、心力衰竭和心源性休克。可能涉及的毒性机制已被广泛讨论,但尚未明确确立。目前的证据支持其与冠心病继发缺血后的级联反应有共同代谢效应的可能性。基于一例病例报告,我们讨论了其常见临床表现、治疗及预后。最后我们对接受5-氟尿嘧啶治疗的患者管理提出建议。