放射治疗对乳腺癌患者心脏损伤指标影响的Meta分析  

A Meta-analysis of the effects of radiotherapy on cardiac injury indicators in breast cancer patients

作　　者：郑国红[1] 曹钢[1] 杨海芳[1] 米蕊 王晓红[1] ZHENG Guo-hong;CAO Gang;YANG Hai-fang;MI Rui;WNAG Xiao-hong(Department of Radiochemotherapy, People′s Hospital of Tangshan City, Hebei Province, Tangshan 063000, China)

机构地区：[1]河北省唐山市人民医院放化科,河北唐山063000

出　　处：《河北医科大学学报》2022年第5期530-535,共6页Journal of Hebei Medical University

基　　金：河北省医学科学研究课题计划(20190169)。

摘　　要：目的探讨放射治疗(放疗)对乳腺癌患者放射性心肌损伤(radiation induced heard disease,RIHD)指标的影响。方法在PubMed数据库、万方医学、国内医学研究期刊及生物医学文献等医疗数据库中检索文献,以乳腺癌患者应用放疗方案对RIHD评估指标影响为检索方向,检索指标关键词为肌钙蛋白I(cardiac troponin I,cTnI)、肌酸激酶同工酶(creatine kinase isoenzyme-MB,CK-MB)、N末端B型利钠肽原(N-terminal pro-B-type natriuretic peptide,NT-pro BNP)、脑钠肽(brain natriuretic peptide,BNP),在收集的文献基础上应用Rev Man 5.2软件进行Meta分析。结果根据研究对象、方法、疾病类型等标准对检索文献进行筛选,最终纳入符合标准的文献8篇,发表偏倚性较低。Meta分析结果显示:放疗后cTnI、CK-MB、BNP明显高于放疗前,差异有统计学意义(P<0.05);放疗前后NT-pro BNP差异无统计学意义(P>0.05)。敏感性检验结果表示,文献异质性小,具有较高参考价值。结论放疗可使乳腺癌患者cTnI、CK-MB、BNP指标发生明显变化,导致RIHD,应进一步跟进乳腺癌患者放疗方案优化的研究进度,尽可能降低放疗造成的心肌损伤,可将cTnI、CK-MB、BNP作为乳腺癌患者放疗发生RIHD的良好预测指标,为乳腺癌放疗患者及时诊断预防心肌损伤提供参考依据。Objective To investigate the effect of radiotherapy on the radiation-induced heart disease(RIHD)indicators in patients with breast cancer.Methods The literature was searched in the PubMed data base,Wanfang medicine,domestic medical research journals and biomedical literature,and the effect of radiotherapy regimen on evaluation indicators of RIHD was searched.The key indicators were cardiac troponin I(cTnI),creatine kinase isoenzyme-MB(CK-MB),N-terminal pro-B-type natriuretic peptide(NT-pro BNP)and brain natriuretic peptide(BNP).Meta-analysis was performed using Rev Man 5.2 software based on the collected literature.Results The retrieved literature was screened according to the criteria of research subject,method and disease type,and finally 8 literature meeting the criteria was included,with low publication bias.The results of meta-analysis showed that cTnI,CK-MB and BNP after radiotherapy were significantly higher than those before radiotherapy,suggesting significant differences(P<0.05).There was no significant difference in NT-pro BNP before and after radiotherapy(P>0.05).The results of sensitivity test revealed that the literature had little heterogeneity and high reference value.Conclusion Radiotherapy can significantly change the cTnI,CK-MB and BNP of patients with breast cancer,resulting in RIHD.The progress of research on the optimization of radiotherapy regimen for breast cancer patients should be further followed up to minimize RIHD.CTnI,CK-MB and BNP can be used as good predictors of RIHD in radiotherapy for breast cancer patients,thereby providing reference for timely diagnosis and prevention of RIHD in patients with breast cancer.

关 键 词：乳腺肿瘤 放射疗法 放射性心肌损伤 

分 类 号：R737.9[医药卫生—肿瘤]