摘要
目的监测乳腺癌术后患者采用蒽环类药物化疗前、后心功能(心电图、超声心动图)及心脏生化标记物[B型利钠肽(BNP)、肌钙蛋白I(cTnI)]水平的变化,评价其对乳腺癌术后患者蒽环类药物化疗所致早期心脏毒性监测的临床价值。方法收集2014年12月至2016年12月就诊于宁夏医科大学总医院肿瘤医院的191例女性乳腺癌患者,术后均给予蒽环类药物化疗。所有患者均于化疗前及化疗1、4周期后行心电图、超声心动图检查及血清BNP及cTnI水平检测。对所得结果进行详细分析。结果191例乳腺癌术后患者蒽环类药物化疗1、4周期后的心电图异常发生率分别为32.46%、39.79%,比较常见的心电图异常为ST-T改变、窦性心动过缓/过速。乳腺癌术后患者应用蒽环类药物化疗前及化疗1、4周期后的E/A比值呈进行性降低,血清BNP水平呈进行性升高(P<0.01),而血清cTnI水平比较,差异无统计学意义(P>0.05)。结论心电图、超声心动图中E/A比值及血清BNP水平可以作为乳腺癌术后患者蒽环类药物化疗所致近期心脏毒性的监测指标,而cTnI能否作为发现早期心脏毒性的指标,需增加样本采集时间及扩大临床病例数进一步观察验证。
Objective To monitor the changes of cardiac function(electrocardiogram,echocardiography)and cardiac biochemical markers[B type natriuretic peptide(BNP),cardiac troponin I(cTnI)]levels before and after anthracycline chemotherapy in postoperative breast cancer patients,and to evaluate their clinical value in monitoring early cardiotoxicity induced by anthracycline chemotherapy in postoperative patients with breast cancer.Methods A total of 191 women with breast cancer in the cancer hospital of general hospital of Ningxia medical university from December 2014 to December 2016 were enrolled and treated with anthracycline chemotherapy after operation.All patients underwent electrocardiogram,echocardiography examinations,serum BNP and cTnI levels detection before chemotherapy and after 1 cycle and 4 cycles of chemotherapy.The results are analyzed in detail.Results The incidences of electrocardiogram abnormality after 1 cycle and 4 cycles of anthracycline chemotherapy in 191 postoperative patients with breast cancer was 32.46%and 39.79%respectively.The common electrocardiogram abnormalities were ST-T changes and sinus bradycardia/tachycardia.The ratio of E/A before anthracycline chemotherapy and after 1 cycle and 4 cycles of chemotherapy in postoperative breast cancer patients decreased progressively,and the levels of serum BNP increased progressively(P<0.01),while there was no significant difference in serum cTnI level(P>0.05).Conclusion Electrocardiogram,echocardiography E/A ratio and serum BNP level can be used as monitoring indicators for short-term cardiotoxicity induced by anthracycline chemotherapy in postoperative breast cancer patients.Whether cTnI can be used as an indicator of early cardiotoxicity needs to be further observed and verified by increasing the sample collection time and expanding the number of clinical cases.
作者
吕燕
袁春秀
王楠
刘新兰
LYU Yan;YUAN Chunxiu;WANG Nan;LIU Xinlan(General Hospital of Ningxia Medical University,Yinchuan 750004;Ningxia Medical University,Yinchuan 750004,China)
出处
《临床医学研究与实践》
2021年第23期49-51,共3页
Clinical Research and Practice
