心肌钙蛋白I对蒽环类化疗的乳腺癌患者心脏毒性的预测价值.pdfVIP

2011;31(6) 南方医科大学学报（J South Med Univ ） ·1047 · ·临床研究· 心肌钙蛋白I 对蒽环类化疗的乳腺癌患者心脏毒性的预测价值 黄伟斌，姚广裕，刘民锋，陈睿婷，陈路嘉，董建宇，顾 繁，郭昭泽，叶长生 南方医科大学南方医院乳腺中心，广东 广州 510515 摘要：目的评估心肌钙蛋白I(CTnI)对接受含蒽环类方案化疗的乳腺癌患者心脏毒性的预测价值。方法收集186例在南 方医院接受含蒽环类方案化疗的乳腺癌患者的病案资料，记录患者化疗前和每个化疗周期CTnI 浓度及化疗前和首次化 疗开始后第2、4、6 月的左心室射血分数(LVEF)。据文献报道，当患者血清CTnI≥0.1 ng/ml 时，心脏毒性发生率明显升高， 据此我们将患者定义为两组，化疗期间血清CTnI≥0.1 ng/ml 者为CTnI+组（60 例），小于0.1 ng/ml 者为CTnI-组（126例）。 结果所有患者均未出现充血性心力衰竭（CHF）。LVEF 较化疗前下降幅度超过10%的患者CTnI+组出现16例，占26.7% （16/60），而CTnI-组出现7 例，占5.6%（7/ 126），两组间有统计学差异(P0.01)。结论CTnI 可作为早期预测蒽环类化疗药 物引起心脏毒性的指标。 关键词：心肌钙蛋白I ；蒽环类；心脏毒性；乳腺癌 中图分类号：R97 文献标志码：A 文章编号：1673-4254（2011）06-1047-04 Value of cardiac troponin I measurement in prediction of anthracycline-induced cardiotoxicity in breast cancer patients HUANG Wei-bin, YAO Guang-yu, LIU Min-feng, CHEN Rui-ting, CHEN Lu-jia, DONG Jian-yu, GU Fan, GUO Zhao-ze, YE Chang-sheng Breast Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China Abstract: Objective To evaluate the value of cardiac troponin I (CTnI) measurement in predicting anthracycline-induced cardiotoxicity in patients with breast cancer. Methods This study was conducted among 186 breast cancer patients receiving anthracycline-based chemotherapy. Serum cTnI concentrations before and after each cycle of the chemotherapy and the left ventricular ejection fraction (LVEF) before and at the 2nd, 4th and 6th months of the treatment were recorded. According to serum cTnI concentration, the patients were divided into CTnI+ group (with serum CTnI concentration of no less than 0.1 ng/ml, n=60) and CTnI- (0.1 ng/ml) group (n=126). Results No patients in this s