NT-proBNP、cTnI及IMA对柔红霉素致儿童急性白血病心肌损伤的诊断价值  

The diagnostic value of NT-proBNP,cTnI and IMA on daunomycin induced myocardial injury in children with acute leukemia

作　　者：贵艳玲[1] 姬利云 孙银平[2] 

机构地区：[1]新乡医学院第一附属医院,河南453100 [2]新乡医学院基础医学院,河南453000

出　　处：《齐齐哈尔医学院学报》2016年第17期2137-2139,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨NT-pro BNP、c Tn I、IMA对柔红霉素所致儿童急性白血病心肌损伤的早期诊断价值。方法对60例急性白血病患儿分别于应用DNR前及应用DNR达到90mg/m^2、150mg/m^2、240mg/m^2、300 mg/m^2剂量后5个时间点测定NT-pro BNP、c Tn I及IMA浓度,并对其测量值进行分析。结果用药前及应用DNR达90mg/m^2、150mg/m^2、240mg/m^2、300mg/m^2时血清IMA浓度分别为36.0±3.08、36.6±2.60、58.73±20.53、67.37±22.57、78.6±23.1(U/ml),F=58.128,P=0.000;血清c Tn I浓度分别为0.0060±0.0042、0.0073±0.0043、0.0078±0.0045、0.4058±1.2195、1.3405±3.9286(ug/L),F=7.7170,P=0.000;血浆NT-pro BNP浓度分别为76.4±30.65、106,8±185.1、129.7±218.16、211.6±397.2、381.9±615.5(pg/ml),F=5.084,P=0.001;各组组间具有显著差异。结论 IMA、c Tn I及NT-pro BNP血浓度随着DNR剂量增加均增加,可以作为监测DNR致心肌损伤的诊断指标;IMA在DNR达150 mg/m^2时即明显增加,是三者中反应心肌损伤的最敏感指标。Objective To research the diagnostic value of NT- proBNP,cTnI and IMA on daunorubicin induced myocardial injury of children with acute leukemia. Methods We used the enzyme- linked immunosorbent assay（ ELISA） to detect the concentration of NT- proBNP,cTnI and used the micro- particle enzyme immunoassay（ MEIA） to detect and analyzed the concentration of IMA at the time points before the application of DNR,the DNR dose reached 90 mg / m^2,150 mg / m^2,240 mg / m^2,300 mg / m^2. Results The concentration of IMA at different time points were 36. 0 ± 3. 08,36. 6 ± 2. 60,58. 73 ± 20. 53,67. 37 ± 22. 57 and 78. 6 ± 23. 1（ U / ml） respectively,the results had significant difference among groups（ F = 58. 128,P = 0.000）. The concentration of cTnI were 0. 0060 ± 0. 0042,0. 0073 ± 0. 0043,0. 0078 ± 0. 0045,0. 4058 ± 1. 2195 and 1. 3405 ± 3. 9286（ ug / L） respectively,had significant difference between groups（ F = 7. 7170,P = 0. 000）.The concentration of NT- proBNP were 76. 4 ± 30. 65,106. 8 ± 185. 1,129. 7 ± 218. 16,211. 6 ± 397. 2 and381. 9 ± 615. 5（ pg / ml） respectively,had significant difference among groups（ F = 5. 084,P = 0. 001）.Conclusions The concentration of IMA,cTnI and NT- proBNP increased as the dose of DNR increased,it can be used as the diagnosis indicators of DNR induced myocardial damage. IMA is increasing significantly when the dose up to 150 mg / m^2,so IMA is the most sensitive indicator in myocardial injury.

关 键 词：柔红霉素 心肌损伤 N末端B型钠尿肽前体 心肌肌钙蛋白I 缺血修饰蛋白 

分 类 号：R543.3[医药卫生—心血管疾病]