蒽环类药物化疗对乳腺癌术后患者血清心肌、氧化应激标志物及心脏彩超指标的影响及相关性  

The influence and correlation of anthracycline chemotherapy on serum myocardium,oxidative stress markers and echocardiography indexs in patients with breast cancer surgery

作　　者：许小芳 柴姣 朱卫伟[3] XU Xiaofang;CHAI Jiao;ZHU Weiwei(Department of Pharmacy,Anyang Maternal and Child Health Hospital,Anyang 455000,He’nan,China;Department of Pharmacy,Anyang Third People’s Hospital,Anyang 455000,He’nan,China;Department of Laboratory Medicine,Anyang Cancer Hospital,Anyang 455000,He’nan,China)

机构地区：[1]安阳市妇幼保健院药剂科,河南安阳455000 [2]安阳第三人民医院药剂科,河南安阳455000 [3]安阳市肿瘤医院检验科,河南安阳455000

出　　处：《癌症进展》2021年第2期167-170,共4页Oncology Progress

摘　　要：目的探讨蒽环类药物化疗对乳腺癌术后患者血清心肌、氧化应激标志物及心脏彩超指标的影响及相关性。方法将200例乳腺癌根治术术后接受蒽环类药物化疗的乳腺癌患者作为观察组,同期选取在本院进行健康体检的120例女性体检者作为对照组,检测观察组化疗前后、对照组体检时(默认为化疗前)的血清心肌标志物[肌钙蛋白(ⅡcTnⅡ)、乳酸脱氢酶(LDH)、肌酸磷酸激酶同工酶(CK-MB)、α-羟丁酸脱氢酶(α-HBDH)]、氧化应激标志物[一氧化氮(NO)、丙二醛、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)]及心脏彩超指标[左心室射血分数(LVEF)、左心室舒张期末容积指数(EDVI)、左心室收缩期末容积指数(ESVI)、左心室整体纵向应变(GLS)、左心室整体径向应变(GRS)及心肌综合指数(MCI)]。结果化疗前,两组受试者血清心肌标志物、氧化应激标志物、心脏彩超指标比较,差异均无统计学意义(P﹥0.05)。化疗后,观察组患者血清c TnⅡ、LDH、CK-MB、α-HBDH、NO、丙二醛水平均高于本组化疗前和对照组受试者,GSH-PX、SOD、GLS、MCI水平均低于本组化疗前和对照组受试者,差异均有统计学意义(P﹤0.05)。乳腺癌患者血清cTnⅡ、LDH、CK-MB、α-HBDH水平与GLS、MCI、NO、丙二醛呈正相关,与GSH-PX、SOD呈负相关。结论乳腺癌术后患者接受蒽环类药物化疗的心脏毒性可通过血清心肌标志物、心脏彩超指标评价,且氧化应激反应激活是引起心脏毒性的可能机制。Objective To explore the effect and correlation of anthracycline chemotherapy on serum myocardium,oxidative stress markers and echocardiography indexs in patients with breast cancer surgery.Method 200 breast cancer patients with anthracycline chemotherapy after radical mastectomy were selected as the observation group,and 120 female physical examinees in our hospital were selected as the control group.The serum myocardial markers[cardiac troponin I(cTnI),lactate dehydrogenase(LDH),creatine phosphokinase isoenzyme(CK-MB),α-hydroxybutyrate dehydrogenase(α-HBDH)],oxidative stress markers[nitricoxide(NO),malondialdehyde,superoxide dismutase(SOD),glutathione peroxidase(GSH-PX)],and echocardiography indexs[left ventricular ejection fraction(LVEF),left ventricular end diastolic volume index(EDVI),left ventricular end systolic volume index(ESVI),left ventricular global longitudinal strain(GLS),left ventricular global radial strain(GRS)and myocardial composite index(MCI)]were detected before and after chemotherapy in the observation group and physical examination in the control group(the default is before chemotherapy).Result Before chemotherapy,there was no significant difference in serum myocardial markers,oxidative stress markers,and echocardiography indexs between the two groups of subjects(P>0.05).After chemotherapy,the serum levels of cTnI,LDH,CK-MB,α-HBDH,NO and malondialdehyde in the observation group were higher than those in the group before chemotherapy and those in the control group,and the levels of GSH-PX,SOD,GLS and MCI were lower than this group of subjects before chemotherapy and the control group,the difference was statistically significant(P<0.05).Serum cTnI,LDH,CK-MB,α-HBDH levels in breast cancer patients were positively correlated with GLS,MCI,NO and malondialdehyde,and negatively correlated with GSH-PX and SOD.Conclusion The cardiotoxicity of patients receiving anthracycline chemotherapy after breast cancer surgery can be evaluated by serum myocardial markers and echocardiography indexs,and oxid

关 键 词：乳腺癌 化疗 心脏毒性 氧化应激 心脏彩超 

分 类 号：R737.9[医药卫生—肿瘤]