5-氟尿嘧啶心脏毒性综合征。一种难以捉摸的心脏病。
The syndrome of 5-fluorouracil cardiotoxicity. An elusive cardiopathy.
作者信息
Robben N C, Pippas A W, Moore J O
机构信息
Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710.
出版信息
Cancer. 1993 Jan 15;71(2):493-509. doi: 10.1002/1097-0142(19930115)71:2<493::aid-cncr2820710235>3.0.co;2-c.
BACKGROUND
A case of reversible cardiogenic shock linked to 5-fluorouracil (5-FU) was observed. Recognizing the increasing use of 5-FU, the authors tried to map this syndrome.
METHODS
They reviewed 134 additional case reports, retrieved information from literature searches, focused on clinical features, and discussed possible pathophysiologic findings and prevention of this syndrome.
RESULTS
Although angina and electrocardiographic changes were common and reproducible (approximately 90% each), coronary artery disease was found in a few patients. A total of 33 patients had severe left ventricular dysfunction, 28 without evidence of myocardial infarction. The symptoms were responsive to conservative management (90%).
CONCLUSIONS
Cardiac toxicity is a little known complication of 5-FU therapy, with an unknown but significant incidence. It is highly treatable.
背景
观察到1例与5-氟尿嘧啶（5-FU）相关的可逆性心源性休克病例。鉴于5-FU的使用日益增加，作者试图梳理该综合征。
方法
他们回顾了另外134例病例报告，从文献检索中获取信息，重点关注临床特征，并讨论了该综合征可能的病理生理学表现及预防措施。
结果
尽管心绞痛和心电图改变很常见且具有重复性（各约90%），但仅少数患者发现有冠状动脉疾病。共有33例患者出现严重左心室功能障碍，其中28例无心肌梗死证据。这些症状对保守治疗有效（90%）。
结论
心脏毒性是5-FU治疗鲜为人知的并发症，发病率未知但相当可观。该并发症具有很高的可治疗性。
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