作　　者： (周锋）; ;

机构地区： 中山大学

出　　处： 《中国临床药理学杂志》 2018年第22期2594-2597,共4页

摘　　要： 目的探讨N-端脑钠肽前体(NT-proBNP)联合肌钙蛋白(cTnⅠ)对化疗所致心脏毒性的早期诊断意义。方法将80例恶性肿瘤患者作为研究对象,予以50 mg·m^(-2)蒽环类药物吡柔比星(THP)注射剂或60 mg·m^(-2)表柔比星(EPI)注射剂联合500 mg·m^(-2)环磷酰胺(CTX)注射剂化疗,于第1天静脉输入,21 d为1个疗程,共4个疗程。分别在化疗前、化疗第1,2,4疗程结束时检测患者NT-proBNP、cTnⅠ、超声心动图及肌酸激酶同功酶(CK-MB)的数值变化(出现明显心脏毒性者停止化疗)。对比上述4个时间点4个指标的变化。结果化疗前、化疗第1,2,4疗程结束时,患者血清中NT-proBNP分别为(26. 72±2. 53),(83. 64±6. 47),(132. 73±24. 76),(75. 42±27. 83)ng·m L^(-1),cTnⅠ分别为(0. 02±0. 01),(0. 06±0. 01),(0. 08±0. 01),(0. 05±0. 02) ng·m L^(-1),CK-MB为(14. 23±3. 92),(21. 34±4. 79),(22. 26±4. 31),(17. 83±4. 15) U·L^(-1),差异均有统计学意义(均P <0. 05)。相关性分析显示NT-proBNP和cTnⅠ水平与心脏毒性呈正相关,r值分别为0. 895与0. 871(均P <0. 05)。结论 NT-proBNP联合cTnⅠ对化疗所致心脏毒性有较好的早期诊断意义,值得临床推广。 Objective pro - B - type natriuretic Troponin I in the early To investigate the importance of N - terminal peptide （ NT - proBNP） combined with cardiac diagnosis of Cardiac toxicity induced by chemotherapy. Methods Eighty cases or malignant tumor patients were selected as the research objects, and they were given anthracyclines named pirarubicin （THP） 50 mg·m^-2 or epirubicin （EPI） 60 mg·m^-2 combined with Cyclophosphamide （CTX） 500 mg·m^-2 chemotherapy by vein input at the first day, 21 days was a period of treatment, 4 periods in total; Before chemotherapy and at the treatment end of the first, second, fourth period, the NT-proBNP, cardiac troponin I （cTnI）, electrocardiograph （ECG） and creatine kinase isoenzyme （CK- MB ） numerical changes （apparent cardiac toxicity stop chemotherapy） of the patients were detected. And the changes of 4 indicators at the 4 time points were compared and analyzed. Results After the first, second and fourth period of treatment, there were significant differences compared with before treatment in serum NT - proBNP [ （83.64 ± 6. 47 ） ng·mL^-1,（ 132.73±24.76） ng·mL^-1, （75.42±27. 83 ） ng·mL^-1 vs （ 26.72±2. 53 ） ng·mL^-1], cTnI [（0. 06 ± 0.01 ） ng·mL^-1,（0.08±0.01） ng·mL^-1, （0.05±0.02） ng·mL^-1 vs（0.02±0.01）ng·mL^-1] and CK - MB [（21.34±4.79）U·L^-1, （22.26±4.31）U·L^-1,（17.83±4.15）U·L^-1 vs （14.23±3.92）U·L^-1] （ P 〈 0. 05 ）. NT - proBNP and cTnI levels were positively correlated with the degree of cardiac toxicity （ r = 0. 895, P 〈 0. 05 ; r = 0. 871, P 〈 0. 05 ）. Conclusion It was suggested that NT - proBNP combined with cTnI had early diag- nosis meaning for cardiac toxicity caused by chemotherapy, and worth clinical promotion.

关 键 词： 端脑钠肽前体 肌钙蛋白 化疗 心脏毒性

领　　域： [医药卫生—药品] [医药卫生—药学]