使用蒽环类药物化疗的恶性肿瘤患者发生慢性心脏毒性的影响因素分析  

Influencing Factors of Chronic Cardiotoxicity in Patients with Malignant Tumors Treated with Anthracycline Chemotherapy

作　　者：彭美玲 张雪梅[2] PENG Meiling;ZHANG Xuemei(Department of Electrocardiogram,Yangling Demonstration Area Hospital,Xianyang Shaanxi 712100)

机构地区：[1]杨凌示范区医院心电图室,陕西咸阳712100 [2]延安市人民医院功能科,陕西延安716000

出　　处：《医学临床研究》2024年第4期551-554,共4页Journal of Clinical Research

摘　　要：【目的】探讨使用蒽环类药物化疗的恶性肿瘤患者发生慢性心脏毒性的影响因素。【方法】收集两院收治的64例接受蒽环类药物治疗的恶性肿瘤患者的临床资料,根据化疗1年内患者是否发生慢性心脏毒性将其分为毒性组(25例)及非毒性组(39例)。比较两组患者基线资料,心电图(ECG)异常情况及患者肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)水平,通过使用受试者工作特征(ROC)曲线及多因素Logistic回归分析患者发生慢性心脏毒性的影响因素。【结果】毒性组cTnI、CK-MB、LDH水平高于非毒性组,ECG异常情况发生率高于非毒性组(P<0.05)。ROC分析显示:cTnI、CK-MB、LDH可用于评估患者慢性心脏毒性的发生,曲线下面积分别为0.746、0.889、0.785(P<0.05)。经多因素Logistic回归分析证实,cTnI>84.430 ng/mL、CK-MB>28.692 IU/L、LDH>203.292 IU/L、ST-T段改变、T波异常、窦性心动过速、房室传导阻滞均是影响患者发生慢性心脏毒性的危险因素(P<0.05)。【结论】T波异常、cTnI>84.430 ng/mL、CK-MB>28.692 IU/L、LDH>203.292 IU/L、ST-T段改变、窦性心动过速、房室传导阻滞均是影响使用蒽环类药物化疗患者发生慢性心脏毒性的危险因素,可为临床早期干预提供可靠参考依据。【Objective】To explore the influencing factors of chronic cardiotoxicity in patients with malignant tumors treated with anthracycline chemotherapy.【Methods】The clinical data of 64 patients with malignant tumors treated with anthracyclines in two hospital were collected.According to whether the patients had chronic cardiotoxicity within 1 year of chemotherapy,they were divided into toxic group(25 cases)and non-toxic group(39 cases).The baseline data,ECG abnormalities,cardiac troponin I(cTnI),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH)levels of patients in the two groups were compared.The influencing factors of chronic cardiotoxicity in patients were analyzed by using receiver operating characteristic(ROC)curve and multivariate logistic regression.【Results】The levels of cTnI,CK-MB and LDH in the toxic group were higher than those in the non-toxic group,and the incidence of ECG abnormalities in the toxic group was higher than that in the non-toxic group(P<0.05).ROC analysis showed that cTnI,CK-MB and LDH could be used to evaluate the occurrence of chronic cardiotoxicity in patients,and the areas under the curve were 0.746,0.889 and 0.785,respectively(P<0.05).Multivariate logistic regression analysis confirmed that cTnI>84.430 ng/mL,CK-MB>28.692 IU/L,LDH>203.292 IU/L,ST-T segment changes,T wave abnormalities,sinusachycardia,atrioventricular block were the risk factors of chronic cardiotoxicity(P<0.05).【Conclusion】cTnI>84.430 ng/mL,ST-T segment changes,CK-MB>28.692 IU/L,LDH>203.292 IU/L,T wave abnormalities,sinus tachycardia,atrioventricular block are the risk factors of chronic cardiotoxicity in patients treated with anthracycline chemotherapy,which can provide a reliable reference for early clinical intervention.

关 键 词：肿瘤/药物疗法 蒽环类/毒性 心脏毒性 影响因素分析 

分 类 号：R73[医药卫生—肿瘤]