血清细胞因子TGF-β1和IL-1β表达水平对急性放射性心脏损伤发生的影响  

Effect of TGF-β1 and IL-1β expression in serum on acute radiation-induced heart disease

作　　者：王祎[1] 王军[1] 程云杰[1] 刘青[1] 张萍[1] 吴凤鹏[1] 万欣[1] 张钧[1] 

机构地区：[1]河北医科大学第四医院放疗一科,石家庄050011

出　　处：《中华放射医学与防护杂志》2012年第5期488-491,共4页Chinese Journal of Radiological Medicine and Protection

基　　金：基金项目：河北省二00九年医学科学研究重点课题（20090502）

摘　　要：目的研究胸部肿瘤放射治疗患者血清TGF-β1和IL-1β水平对急性放射性心脏损伤发生的影响。方法接受常规适形或调强放疗的胸部肿瘤患者54例，PTV处方剂量为50-66Gy，分析靶区剂量分布及危及器官受量。患者于放疗前及放疗结束后空腹采肘静脉血，应用酶联免疫吸附法检测血清中TGF-β1和IL-1β水平，并分别在放疗前后和放疗开始90d内检测心肌酶、肌钙蛋白I、心电图以及心功能指标评价患者心脏损伤状况，对急性放射性心脏损伤分级标准进行评价。分析血清TGF-β1和IL-1β水平对急性放射性心脏损伤的影响。结果放疗前患者血清TGF—β1为（888．4±41．1）μg／L，放疗结束时为（926．1±23．1）μg／L，差异有统计学意义（t=-6．479，P〈0．05）；放疗后发生急性放射性心脏损伤患者血清TGF．B1为（900．6±34．5）μg／L，高于无急性放射性心脏损伤患者的（865．7±47．0）μg／L，差异有统计学意义（t=-2．646，P〈0．05）。Spearman相关分析显示，TGF-β1放疗前基础水平、放疗前后差值与急性放射性心脏损伤相关（r=0．378、0．311，P〈0．05）。患者放疗前与放疗结束时的血清IL-1β比较差异无统计学意义；放疗后发生急性放射性心脏损伤者与未发生急性放射性心脏损伤者血清IL-1β基础表达水平差异无统计学意义。患者放疗前IL-1β基础水平、放疗后表达水平、放疗前后差值与急性放射性心脏损伤无相关性。放疗前、后TGF—β1的表达水平与放疗后IL-1β的表达水平呈正相关（r=0．416、0．389，P〈0．05）。结论放疗后血清TGF—β1升高，放疗前基础表达水平及放疗前后差值与急性放射性心脏损伤相关。IL-1β与放射性心脏损伤无相关性。Objective To evaluate the effect of TGF-1β and IL-1β expression in serum on acute radiation-induced heart disease （RIHD） in patients with thoracic tumors. Methods Three-dimensional conformal radiotherapy （3D-CRT） or intensity modulated radiotherapy （IMRT） was delivered at 1.8 - 2. 0 Gy, 5 times per week to a total dose of 50 -66 Gy to 44 patients with lung cancer and 10 patients with esophagus cancer. The target and organs at risk dose distribution were analyzed by 3-dimensiond treatment planning system. The expressions of TGF-β1 and IL-1β in serum were detected by enzyme linked immunosorbent assay before and at the end of the irradiation. The cardiac injury was evaluated by detecting the cmyocardium creatase,cardiac troponin I （cTnI） , electrocardiogram and cardiac function before and at the end of the irradiation within 90 d. The acute RIHD was evaluated by the Common Terminology Criteria V 3.0 （NCI-CTCAE 3.0）. The expressions of TGF-β1 and IL-1β in the serum of RIHD patients with thoracic tumors were analyzed. Results The expression of TGF-β1 in serum was （888.4 ± 41.1 ） μg/L before the irradiation and approached to （926.1 ± 23.1 ）μg/L at the end of the radiotherapy. The expression level of TGF-β1 in the serum of acute RIDH group was （900.6 ±34. 5） μg/L, higher than thatof normal group [ （865.7 ±47.0） ixg/L, t = -2. 646, P 〈0. 05） ]. The acute RIDH was correlated with the expression level of TGF-β1 before irradiation and the difference before and at the end of irradiation （r = 0. 378,0. 311, P 〈 0. 05）. The IL-1β expression had no significant difference before and after irradiation. The expression of TGF-1β in serum before and at the end of irradiation had positive correlation with the expression oflL-1β at the end of the irradiation （r = 0.416,0.389, P 〈0.05）. Conclusions The expression of TGF-1β in the serum of patients with thoracic tumor inereases after irradiation and correlated with the acute RIHD, but the expression of IL-1β in ser

关 键 词：三维适形放射治疗 调强放射治疗 放射性心脏损伤 转化生长因子-β1 白介素-1Β 

分 类 号：R730.55[医药卫生—肿瘤]