胸部肿瘤病人放疗中血清心肌酶学的变化

Changes of Serum Myocardiac Enzymology for Patients with Radiotherapy on Chest

目的：观察心肌受照射面积及照射剂量对血清心肌酶学改变的影响。方法：对８６例射野累及心脏的肺癌和食管癌病人行６０Ｃｏ线照射，并在照射前、照射中和照射结束时检测血清ＬＤＨ、ＡＳＴ、ＣＫ及ＣＫ－ＭＢ浓度的改变，同时行心电图检查。结果：①血清ＬＤＨ及ＡＳＴ浓度无显著改变。②血清ＣＫ浓度在心脏受照射面积占心脏面积５０％以上，且照射剂量高于６０Ｇｙ时出现升高。③血清ＣＫ－ＭＢ浓度在心脏受照射面积占心脏面积５０％以上时出现升高。④有２例患者心电图出现ＳＴ段改变，占全部病例的２．３％。结论：血清ＣＫ浓度的改变与心脏受照射面积及照射剂量相关，血清ＣＫ－ＭＢ浓度的改变仅与心脏受照射面积相关。

Objective: Our aim was to study the influence of radiotherapy area and dose of the heart on serum myocardiac enzymology for the patients received radiotherapy on chest. Methods: Eightysix patients with lung cancer or esophagus cancer were irradiated with 60Co ray and the radioactive region involved the patientsheart. The values of the LDH, AST, CK and CKMB in the serum were measured before irradiation, in the middle of irradiation, and at the end of irradiation, respectively. ECG was examined at the same time. Results: The values of the LDH and AST in the serum did not change obviously. The value of CK increased when more than 50% area of the heart was irradiated and dose were more than 60 Gy. When the irradiation area were more than 50%, the value of the CKMB increased, too. The ST segment in the electrocardiogram for 2 patients (2.3%) showed changes ofter radiotherapy. Conclusion: The change of the CK in the serum was related to radioactive area of the heart and dose. The change of CKMB was related only to radioactive area.