表柔比星相关心肌损伤患者血清NT-proBNP改变及临床意义  

The Changes and Clinical Significance of NT-pro BNP on Epirubicin Associated Cardiac Toxicity

作　　者：谢文卫[1] 吴雪琴[1] 周益萍[1] 徐正琴[1] 沈红粉 于婷[1] 

机构地区：[1]金坛市中医医院检验科,江苏金坛213200

出　　处：《医学综述》2015年第22期4197-4199,共3页Medical Recapitulate

摘　　要：目的探讨表柔比星相关心肌损伤患者血清N端脑钠肽前体(NT-pro BNP)改变及临床意义。方法选择2013年1月至2014年6月于常州市金坛区中医医院住院并接受表柔比星化疗的乳腺癌患者80例,根据是否出现心脏毒性症状分为心脏毒性组(13例)和对照组(67例),动态观察化疗开始前、化疗第2个周期前、第4个化疗周期后1周的超声心动图和NT-pro BNP水平改变。结果化疗后,患者左心功能出现了不同程度的损伤。心脏毒性组患者NT-pro BNP水平在3个检测时间点中逐渐上升(P<0.05)。血清NT-pro BNP水平在化疗的2个周期后和疗程结束后与LVEF呈负相关(P<0.05)。第2个周期前的NT-pro BNP水平具有较高的早期诊断价值,当NT-pro BNP水平升高超过63.7 ng/L时,早期诊断心功能损伤的曲线下面积(AUC)为0.77,灵敏度为75.0%,特异度为82.0%,阳性预测值为0.90,阴性预测值为0.60。结论 NT-pro BNP有望成为早期诊断和预警蒽环类抗生素化疗相关心脏毒性的生物学标志物。Objective To evaluate the changes and clinical significance of N terminal probrain natri- uretic peptide （NT-proBNP） on epirubicin associated cardiac toxicity. Methods Eighty breast cancer patients treated with epirubicin chemotherapy admitted to Changzhou City Jintan Hospital of Traditional Chi- nese Medicine from Jan. 2013 to Jun. 2014 were divided into two groups：cardiac toxicity group（ n = 13 ） and control group（ n = 67 ）. Echocardiography and levels of NT-proBNP in serum were measured at three time points： the day before chemotherapy, before second chemotherapy cycle and one week after the fourth chemo- therapy cycle. Results The patients showed left cardiac function injury of different degrees after chemother- apy. In the group of cardiac toxicity, the levels of NT-preBNP showed gradual increase at the 3 time points （ P 〈 0. 05 ）. The correlation analysis suggested that the levels of NT-preBNP showed a negative relationship with LVEF after two cycles of chemotherapy （ P 〈 0.05 ）. The ROC analysis showed the NT-proBNP level before the second cycle had high value for early diagnosis. When the level of NT-preBNP was more than 63.7 ng/L,the AUC, sensibility, specificity, positive predictive value and negative predictive value were 0. 77, 75.0%, 82.0%,0. 90 and 0. 60 respectively. Conclusion NT-proBNP may serve as a convenient serum biomarker for the early detection of cardiotoxicity induced by anthraeycline.

关 键 词：心肌损伤 表柔比星 N端脑钠肽前体 临床意义 

分 类 号：R541[医药卫生—心血管疾病]