放射治疗心脏损伤患者血浆肌钙蛋白Ⅰ、心肌酶谱、脑钠肽水平的变化  

Changes of Plasma Troponin I,Myocardial Enzyme and Brain Natriuretic Peptide in Patients with Cardiac Injury Treatedwith Radiation Therapy

作　　者：高东奇[1] 张晶晶[1] 李富博[1] 白璐[1] 李青山[1] GAO Dong-qi;ZHANG Jing-jing;LI Fu-bo;BAI Lu;LI Qing-shan(Department of Oncology,Affiliated Hospital of Chengde Medical College,Chengde 067000,China)

机构地区：[1]承德医学院附属医院肿瘤科,河北承德067000

出　　处：《标记免疫分析与临床》2019年第2期208-211,263,共5页Labeled Immunoassays and Clinical Medicine

基　　金：承德市科技支撑计划项目申请书(编号:20142056)

摘　　要：目的探讨放射治疗过程中血浆肌钙蛋白I、心肌酶谱及脑钠肽水平在放射性心脏损伤(radiation-induced heart disease,RIHD)中的诊断价值。方法对60例经放射治疗的胸部恶性肿瘤患者进行常规心电图检查及血浆肌钙蛋白I、心肌酶谱指标及脑钠肽检测,并比较分析放疗前、放疗2周、4周、6周各指标的变化。结果放射治疗过程中,异常心电图主要集中在第4-6周,发生率为38.33%(23/60)。肌钙蛋白I和心肌酶谱异常比例分别为35%(21/60)和31. 67%(19/60),放射治疗6周时两项检测内容升高最明显(P <0.05)。乳酸脱氢酶指标在放疗前后变化无明显差异(P>0. 05)。放射治疗后,相比非RIHD患者,RIHD患者脑钠肽水平升高显著,于放射治疗开始6周达92.73±8. 91 ng/L,且具有统计学意义(P<0.05)。结论心电图改变是RIHD常见现象,血浆肌钙蛋白I、心肌酶谱及脑钠肽水平可作为RIHD早期诊断指标。Objective To study the clinical values of plasma troponin I,myocardial enzymes and brain natriuretic peptide in patients with radiation-induced heart disease (RIHD). Methods A total of 60 patients with chest tumor were examined with routine electrocardiogram,also tested for plasma troponin I,myocardial enzymes and brain natriuretic peptide. The changes of the four indexes were analyzed before and after the radiotherapy in the second,fourth,and sixth weeks,respectively. Results The data showed that the electrocardiogram abnormality mostly occurred during the first 4-6 weeks of radiation,and the incidence was 38.33%(23/60). The incidences of plasma troponin I and myocardial enzymes abnormality were 35%(21/60)and 31.67%(19/60),respectively. The plasma troponin I and myocardial enzymes abnormality increased mostly significant at sixth week during the treatment ( P <0.05). There was no significant difference in the indexes of lactate dehydrogenase before and after the radiotherapy ( P >0.05). The level of brain natriuretic peptide in RIHD patients reached 92.73±8.91 ng/L at the sixth week of the radiotherapy,which was significantly higher than that in non-RIHD patients ( P <0.05). Conclusion The changes of electrocardiogram is the most common abnormality of the patients with RIHD. Plasma troponin I,myocardial enzymes and brain natriuretic peptide could be used as the early diagnostic indicators of RIHD.

关 键 词：放射性心脏损伤 肌钙蛋白I 心肌酶谱 脑钠肽 

分 类 号：R730.55[医药卫生—肿瘤] R730.43[医药卫生—临床医学]