缺血修饰白蛋白与心肌酶CK-MB在多柔比星导致心肌毒性反应中的诊断价值  

Ischemia-modified albumin and CK-MB test on the diagnosis of myocardial toxicity myocardial toxic induced by Doxorubicin

作　　者：马英桓[1] 李成浩[1] 李鹏[1] 朱海燕[1] 马怡然[2] 

机构地区：[1]中国人民解放军第四六三医院肿瘤科,辽宁沈阳110042 [2]中国医科大学附属第一医院输血科,辽宁沈阳110001

出　　处：《现代肿瘤医学》2012年第11期2396-2400,共5页Journal of Modern Oncology

摘　　要：目的:探讨缺血修饰白蛋白(IMA)对多柔比星导致急性心肌毒性反应早期诊断的临床意义,对多柔比星导致急性心肌毒性反应患者作出早期诊断及预测。方法:选取用多柔比星治疗的101例患者,根据临床表现、心电图、患者IMA和CK-MB血清结果将患者血清分为发病人群发病时血清(A组)、发病人群给药24h后血清(B组)、高危人群给药24h后血清(C组)及未发病人群给药24h后血清(D组)四组,对四组中的血液指标检验结果比较其差异;并对101名多柔比星诱发的急性心肌毒性患者的538份心电图与538份血清中的IMA指标升高例数进行相关性分析。结果:A组血清与D组血清IMA升高例数差异具有统计学意义(P<0.01);而CK-MB升高例数差异无统计学意义(P>0.05);B组血清与D组血清中IMA及CK-MB升高例数差异具有统计学意义(P<0.01);A组与B组人群血清结果 IMA升高例数差异无统计学意义(P>0.05);而CK-MB升高例数差异有统计学意义(P<0.01);发生急性心肌毒性反应患者中IMA的升高与心电图之间存在着相关性(P<0.05)。结论:多柔比星急性心肌毒性反应患者的缺血修饰白蛋白血液检验指标的异常提示缺血修饰白蛋白检测对诊断多柔比星心肌毒性反应存在一定价值。Objective：Investigating the clinical significance of ischemiamodified albumin on the early diagnosis of acute myocardial toxicity induced by Doxorubicin.Methods： Total of 101 patients treated by Doxorubicin were selected who were divided into disease group（group A）,disease group after giving drugs 24 hours（group B）,high-risk group after giving drugs 24 hours（group C） and no disease group after giving drugs 24 hours（group D） according to the clinical manifestations and ECG and myocardial enzyme CK-MB（CK-MB）.And correlation between 538 ECGs and 538 IMA-increasing cases of acute myocardial toxicity patient was analyzed.Results： The increased numbers of IMA blood parameters have statistically significant differences and no statistically significant differences in CK-MB blood parameters between the patient group with the normal group,P〈0.01 and P〈0.05;The increased numbers of IMA and CK-MB blood parameters have statistically significant differences between the patient group after given drugs 24 hours with the normal group,P〈0.01;The increased numbers of CK-MB blood parameters have statistically significant differences and no statistically significant differences in IMA blood parameters between the patient group with the patient group after given drugs 24 hours,P〈0.05 and P〈0.01;Abnormal electrocardiograms correlated with abnormal IMA blood parameters in acute myocardial toxicity patients induced by Doxorubicin,r=0.762,P〈0.05.Conclusion： Abnormal results of ischemia modified albumin in patients with acute myocardial toxicity induced by Doxorubicin suggest ischemia modified albumin is contributed to the diagnosis of acute myocardial toxicity induced by Doxorubicin.

关 键 词：多柔比星 缺血修饰白蛋白 急性心肌毒性反应 人血清白蛋白 

分 类 号：R730.5[医药卫生—肿瘤]