心肌钙蛋白Ⅰ联合心电图预测乳腺癌TA化疗方案的心脏毒性的价值.docVIP

心肌钙蛋白I联合心电图预测乳腺癌TA化疗方案的心脏毒性的价值 ［ ］目的分析心肌钙蛋白I (CTnl)联合体 表心电图对接受TA方案化疗的乳腺癌患者心脏毒性 的预测价值。方法选取137例乳腺癌患者，通过15 导联心电图检查患者化疗前后的心脏节律及R波振幅、 S「T变化，并记录化疗前后患者CTnl浓度、左心室射 血分数(LVEF)。结果 化疗前患者血清CTnl浓度为 (0.014±0.012) ng/L,体表心电图检查无异常；化疗 第一疗程、第二疗程和第三疗程后患者血清CTnl浓度 分别增加到(0.034±0.013) ng/L、(0.121±0.046) ng/L 和(0.238±0.128) ng/L,且 LVEF 下降超过 10%的患 者人数分别达到36、54和71例，同时化疗后1天、1 周、1个月时患者的心电图异常率分别为82.5%、55.47% 和40.0%。结论CTnl联合心电图可作为早期预测TA 化疗方案引起心脏毒性的指标。 ［关键词］心肌蛋白I ;心电图；乳腺癌；阿霉素 化疗；心脏毒性 ［ ］R737.9 ［ ］B ［ ］ 1673-9701 (2011) 33-17-02 Value of Cardiac Troponin I and Electrocardiography Measurement in Predict!on of TA?induced Cardiotoxicity in Breast Cancer Patients HUANG Jie LI Simin LIANG Jinhua Cancer Center of the Second People s Hospital of Zhanjiang City in Guangdong Province，Zhanjiang 524003, China [Abstract] Objective To an a lyze the value of cardiac trop onin I (CTn I) a nd electrocardiography measureme nt in predict!ng TA-induced cardiotoxicity in patients with breast can cer. Methods This study was con ducted among 137 breast cancer patients， to investigate the heart rhythm, the voltage of R wave, the change of ST-T by 15-lead ECGs and serum CTnI concentrations and the left ve ntricular ejectio n f ractio n (LVEF) before a nd after each cycle of the chemotherapy? Results The serum CTnI concentrations of patients were(0.014±0.012)ng/L and no abnormal ECGs before the chemotherapy? After the first period of chemotherapy, the second course and the third course, the serum CTnI concentrations of patients increased to(0.034±0.013 )ng/L (0.121 ±0.046)ng/L^ (0.238±0.128)ng/L and the number of patients with a LVEF reduction by over 10% were 36、54 and 71 separately. Furthermore， the incidenee of abnormal ECGs were 82.5%、55.47% and 40.0%. Conclusion CTnl and electrocardiography can be a useful marker for early prediction of TA?induced cardiotoxicity in patients with breast cancer. [Key words] Cardiac troponin I； Electrocardiography； Breast cancer； TA； Cardiotoxicity 新辅助化疗是降低晚期乳腺癌局部术后发生复发 和转移的发生率及提高生存率和生活