Ensley J F, Patel B, Kloner R, Kish J A, Wynne J, al-Sarraf M
Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan.
Invest New Drugs. 1989 Apr;7(1):101-9. doi: 10.1007/BF00178196.
5-fluorouracil (FUra) is one of the most frequently used drugs in cancer treatment, particularly in combination with other agents. Its activity when administered as an infusion rather than a bolus has led to a renewed and increased use. A cardiotoxicity that mimics ischemia has been associated with the administration of FUra in cancer patients. This cardiotoxicity may manifest itself as: (a) dysrythmias with and without cardiorespiratory symptoms (b) ECG changes with and without cardiorespiratory symptoms (c) cardiorespiratory symptoms with and without ECG changes (d) acute myocardial infarct; symptoms and ECG changes (e) ventricular dysfunction (f) cardiogenic shock and (g) sudden death. Several case studies which illustrate the cardiotoxic sequelae that may be associated with the use of this drug are discussed. The incidence, contributing factors, risk factors and mechanisms underlying this phenomenon are undetermined. No appropriate recommendations for monitoring patients or for predicting those patients that will develop such toxicity while receiving FUra can be made at present. Prospective studies to determine the true incidence, spectrum and mechanisms causing this syndrome are ongoing and required for its understanding and prevention.
5-氟尿嘧啶（FUra）是癌症治疗中最常用的药物之一，尤其是与其他药物联合使用时。与静脉推注相比，持续静脉输注该药时其活性更高，这使得其使用量重新增加。在癌症患者中，使用FUra与一种类似缺血的心脏毒性有关。这种心脏毒性可能表现为：（a）伴有或不伴有心肺症状的心律失常；（b）伴有或不伴有心肺症状的心电图改变；（c）伴有或不伴有心电图改变的心肺症状；（d）急性心肌梗死；症状和心电图改变；（e）心室功能障碍；（f）心源性休克；（g）猝死。本文讨论了几个病例研究，这些研究说明了使用该药可能出现的心脏毒性后遗症。这种现象的发生率、促成因素、危险因素和潜在机制尚未明确。目前，对于在接受FUra治疗时监测患者或预测哪些患者会出现这种毒性，尚无合适的建议。正在进行前瞻性研究以确定导致该综合征的真实发生率、范围和机制，这对于理解和预防该综合征是必要的。
