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

Value of Cardiac TroponinⅠ and Electrocardiography Measurement in Prediction of TA-induced Cardiotoxicity in Breast Cancer Patients

目的分析心肌钙蛋白I(CTn I)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、ST-T变化,并记录化疗前后患者CTnI浓度、左心室射血分数(LVEF)。结果化疗前患者血清CTnI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CTnI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 CTnI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。

Objective To analyze the value of cardiac troponin I （ CTn I ） and electrocardiography measurement in predicting TAinduced cardiotoxicity in patients with breast cancer. Methods This study was conducted 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 ventricular ejection fraction （ LVEF ） before and 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 incidence of abnormal ECGs were 82.5%,55.47% and 40.0%. Conclusion CTnI and electrocardiography can be a useful marker for early prediction of TA-induced cardiotoxicity in patients with breast cancer.