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

作　　者：王惠 桂鸣[2] 雍永宏 

机构地区：[1]江苏省妇幼保健院,江苏南京210036 [2]江苏省人民医院,江苏南京210036

出　　处：《实用肿瘤杂志》2011年第5期486-489,共4页Journal of Practical Oncology

摘　　要：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。Objective To detect the clinical significance of serum cardiac treponin T（cTnT） and ultrasonic cardiogram in early detection of anthracycline cardiotoxicity. Methods Seventy-eight patients who had been scheduled to receive anthracycline-containing combination chemotherapy were included in the study.Serum cTnT levels and ultrasonic cardiogram parameters,including the left ventricular ejection fraction（LVEF）,fractional shortening（FS）,early peak flow/atrial flow velocity（E/A） ratio and the isovolemic relaxation time（IRT）,were measured before chemotherapy and after the first cycle and the sixth cycle of chemotherapy. Results Seventy-eight patients who completed six cycles of chemotherapy had involved in the statistical analysis.Compared with pro-chemotherapy,cTnT increased obviously after the first and the sixth cycle of chemotherapy（P0.05）,but LVEF and FS had no changes（P0.05）.There was no change of E/A and IRT after the first cycle of chemotherapy（P0.05）,but E/A decreased and IRT prolonged after the sixth cycle of chemotherapy（P0.05）. Conclusions The increase of cTnT level can be a marker in early detection of anthracycline cardiotoxicity,while ultrasonic cardiogram parameters had no change.

关 键 词：乳腺肿瘤 药物疗法 蒽环类 CTNT 超声心动图 药物毒性 

分 类 号：R595.3[医药卫生—内科学]