乳腺癌术后蒽环类化疗药物致心脏损害的早期监测分析
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篇名: 乳腺癌术后蒽环类化疗药物致心脏损害的早期监测分析
TITLE:
摘要: 目的:考察乳腺癌术后蒽环类化疗药物致心脏损害患者的心电图(ECG)、血清心肌肌钙蛋白Ⅰ(cTnⅠ)、血清乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)和肌酸激酶同功酶(CKMB)的早期变化情况,探讨其在心脏损害早期诊断中的意义。方法:回顾性分析我院2015年1月-2016年6月乳腺癌术后以蒽环类药物为主进行化疗的152例病例资料,根据药物性心脏毒性诊断标准,评价其住院及1年随访过程中是否发生心脏损害,根据评价结果分为损害组50例和对照组102例。在患者接受蒽环类药物化疗前(T0)、第1个周期结束后24 h(T1)、第2个周期结束后24 h(T2)及第4个周期结束后24 h(T3)分别检测ECG、cTnⅠ、LDH、CKMB、α-HBDH水平。结果:T1、T2、T3时,损害组患者ECG异常比例显著高于对照组,cTnⅠ、LDH、CKMB、α-HBDH均显著高于对照组,差异均有统计学意义(P<0.01)。结论:早期联合监测ECG、cTnⅠ和心肌酶LDH、CKMB、α-HBDH,能够提高乳腺癌术后蒽环类化疗药物致心脏损害的早期诊断效率,改善患者的预后。
ABSTRACT: OBJECTIVE: To investigate the early changes of ECG, cTnⅠ, LDH, α-HBDH and CKMB in patients with anthracyclines chemotherapy-induced heart damage after breast cancer surgery, and to explore their significances in the diagnosis of early heart damage. METHODS: Medical information of 152 cases of anthracyclines chemotherapy after breast cancer surgery in our hospital during Jan. 2015-Jun. 2016 were analyzed retrospectively. According to diagnosis criteria of drug-induced cardiotoxicity, the occurrence of heart damage was evaluated during hospitalization and 1-year follow-up. According to evaluation results, those patients were divided into heart damage group(50 cases) and control group (102 cases). The early changes of ECG, cTnⅠ, LDH, CKMB and α-HBDH were analyzed before chemotherapy (T0), 24 h after first chemotherapy (T1), 24 h after second chemotherapy (T2), 24 h after forth chemotherapy. RESULTS: At T1,T2,T3, the proprotion of ECG abnormalities in heart damage group was significantly higher than control group; the serum levels of cTnⅠ, LDH, CKMB and α-HBDH in heart damage group were significantly higher than control group, with statistical significance (P<0.01). CONCLUSIONS: For anthracyclines chemotherapy drugs-induced heart damage after breast cancer surgery, early regular monitoring of ECG, cTnⅠ, LDH, CKMB and α-HBDH can improve the efficiency of early diagnosis of heart damage, and improve prognosis.
期刊: 2017年第28卷第17期
作者: 齐宇新,刘姣,何颖娜,任艳青
AUTHORS: QI Yuxin,LIU Jiao,HE Yingna,REN Yanqing
关键字: 乳腺癌;蒽环类药物;心脏损害;心电图;心肌酶;化疗
KEYWORDS: Breast cancer; Anthracyclines; Heart damage; ECG; Myocardial enzyme; Chemotherapy
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