阿霉素持续静脉点滴与静脉推注给药的毒性的对比分析

Comparative Analysis of Adriamycin Toxicity between Continuous Infusion and Bolus Infusion

目的 对比分析阿霉素(ADM )持续静脉点滴与静脉推注治疗恶性肿瘤时的心脏、血液及消化道毒性。方法 恶性肿瘤病例共70例,分为阿霉素持续静脉点滴组(CI组)和阿霉素静脉推注组(BL组) ,CI组应用ADM 60～90mg/m2 持续静脉点滴72～96h ,BL组应用ADM 5 0～60mg/m2 静脉推注3 0min ,分别观察用药后的心脏、肝脏、血液及消化道毒性。结果 CI组与BL组比较,ADM累积剂量>40 0mg/m2 时心脏毒性有显著性差异(P <0 .0 5 ) ;在ADM累积剂量>2 0 0～3 0 0mg/m2 时2组肝脏毒性有显著性差异(P <0 .0 5 ) ,>3 0 0mg/m2 时有非常显著性差异(P <0 .0 1) ;血液学毒性无显著性差异(P >0 .0 5 ) ;消化道毒性有非常显著性差异(P <0 .0 1)。结论 ADM持续静脉点滴与静脉推注比较,持续静脉点滴能减少心脏、肝脏及消化道毒性,不能减轻血液学毒性。

Objective To compare the adriamycin(ADM) toxicities of cardiac,liver,blood and digestive system when administered by continuous infusion(CI) and bolus infusion(BL) in malignant tumor.Methods 70 cases of malignancy patients are divided into 2 groups to receive either 72～96 hour continuous infusion of ADM(CI group,60～90 mg/m2,n=35) or 30-minute bolus infusion of ADM(BL group,50～60 mg/m2,n=35).The toxicities in cardiac,liver,blood and digestive system were observed.Results When the total dose of ADM was over 400 mg/m2,there was a significant difference in cardiac toxicity between these two groups(P<0.05).The liver toxicity was different between these two groups when the total dose of ADM was between 200～300 mg/m2(P<0.05) and was more significantly different when it was over 300 mg/m2.There was also a markedly difference in the toxicity of digestive system(P<0.01).But was not in blood toxicity(P>0.05).Conclusion Compared with ADM bolus infusion,ADM continuous infusion can reduce the toxicity cardiac,liver and digestive system,but has no influence on blood toxicity.