血清心肌肌钙蛋白T和超声心动图在蒽环类药物心脏毒性中的意义Clinical significance of serum treponin T and ultrasonic cardiogram in detection of anthracycline cardiotoxicity
王惠,桂鸣,雍永宏
摘要(Abstract):
目的探讨检测血清心肌肌钙蛋白T(cTnT)和超声心动图参数在蒽环类药物早期心脏毒性评价中的临床意义。方法检测使用蒽环类药物化疗的78例恶性肿瘤患者化疗前和第1周期及第6周期化疗结束后血清中cTnT值及超声心动图参数,包括左室射血分数(LEVF)、左室缩短率(FS)、二尖瓣舒张早期流速峰值/二尖瓣舒张晚期流速峰值(E/A)和左室等容舒张时间(IRT)的变化。结果 78例患者完成6周期化疗进入统计分析,和化疗前相比c,TnT在第1周期和第6周期化疗结束后均明显增高(P<0.05),而LVEF和FS没有明显变化(P>0.05),第1周期化疗结束后E/A及IRT无明显变化(P>0.05),第6周期化疗结束后E/A下降(P<0.05)I,RT延长(P<0.05)。结论 cTnT水平升高可以作为评价蒽环类药物早期心脏毒性的一个指标,而超声心动图参数在早期无明显变化。
关键词(KeyWords): 乳腺肿瘤;药物疗法;蒽环类;cTnT;超声心动图;药物毒性
基金项目(Foundation):
作者(Author): 王惠,桂鸣,雍永宏
DOI: 10.13267/j.cnki.syzlzz.2011.05.004
参考文献(References):
- [1]Lipshultz SE.Exposure to anthracyclines duringchildhood causes cardiac injury[J].Semin Oncol2,006,33(Suppl 8):8-14.
- [2]Auner HW,Tinchon C,Linkesch W,et al.Prolongedmonitoring of troponin T for the detection of anthracyclinecardiotoxicity in adults with hematological malignancies[J].Ann Hematol,2003,82(4):218-222.
- [3]付蕾,米明仁.心肌肌钙蛋白测定对心肌损伤判断的临床意义[J].实验与检验医学,2009,27(2):206-206.
- [4]Lindahl B,Toss H,Siegbahn A,et al.Markers ofmyocardial damage and inflammation in relation to longterm mortality in unstable coronary artery disease.FRISCStudy Group.Fragmin during Instability in CoronaryArtery Disease[J].N Engl J Med2,000,343(16):1139-1147.
- [5]Lipshultz SE,Rifai N,Dalton VM,et al.The effect ofdexrazoxane on myocardial injury in doxorubicin-treatedchildren with acute lymphoblastic leukemia[J].N Engl JMed2,0043,51(11):145-153.
- [6]Dolci A,Dominici R,Cardinale D,et al.Biochemicalmarkers for prediction of chemotherapy inducedcardiotoxicity:systematic review of the literature andrecommendations for use[J].Am J Clin Pathol,2008,130(5):688-695.
- [7]邓觐云,王艳华,李翔,等.血清中肌钙蛋白与蒽环类药物累积量的相关性研究[J].中国基层医药,2006,13(10):1623-1624.
- [8]Kilickap S,Barista I,Akgul E,et al.cTnT can be a usefulmarker for early detection of anthracycline cardiotoxicity[J].Ann Oncol2,005,16(5):798-804.
- [9]Romond E,Perez E,Bryant J,et al.Trastuzumab plusadjuvant chemotherapy for operable HER2-positive breastcancer[J].N Engl J Med,2005,53(4):1659-1672.