应用蒽环类药物化疗患者血清瘦素、N-端脑钠肽前体与超声心动图的变化

Aleterations of serum leptin,N-terminal pro-brain natriuretic peptide and echocardiography in patients with anthracycline chemotherapy

目的探讨应用蒽环类药物化疗患者血清瘦素、N-端脑钠肽前体(NT-proBNP)变化及二者与超声心动图之间的关系。方法选取我院住院的女性乳腺癌术后应用蒽环类药物化疗的患者50例,在化疗前、第1疗程结束、第2疗程结束及第4疗程结束监测患者血清瘦素水平及NT-proBNP变化,超声心动图监测左心室射血分数(LVEF)的变化。应用Pearson相关系数分析血清瘦素、NT-proBNP与超声心动图之间的相关性。结果应用蒽环类药物患者化疗前后的血清瘦素及NT-proBNP比较差异均有统计学意义(P<0.01),LVEF化疗前后比较差异有统计学意义(P<0.05);相关性分析显示血清瘦素及NT-proBNP与LVEF呈负相关(分别为r=-0.285、-0.342,均P<0.05)。结论应用蒽环类药物化疗患者随化疗周期的延长血清瘦素水平及NT-proBNP逐渐升高。血清瘦素水平及NT-proBNP与超声心动图中LVEF显著相关,在诊断蒽环类药物致心脏毒性的检测中具有重要的临床意义。

Objective To determine the levels of serum leptin and N-terminal pro-brain natriuretic peptide（NT-proBNP）in patients with anthracycline chemotherapy,and to investigate their relationship with echocardiography. Methods Fifty female breast cancer patients who stayed in the hospital and got postoperative anthracycline chemotherapy were included in this study.The levels of serum leptin,NT-proBNP in the patients were detected,and the left ventricular ejection fraction（LVEF）was evaluated before chemotherapy,at the first course of treatment,at the second course of treatment,and at the fourth course of treatment.The correlations between serum leptin,NT-proBNP and echocardiography were analyzed with Pearson correlation coefficient.Results After the chemotherapy,the levels of serum leptin and NT-proBNP were significantly changed（P 〈0.01）,so was the LVEF（P 〈0.05）.And there were negative correlations between serum leptin,NT-proBNP and LVEF （r=-0.285,-0.342,bothP〈0.05）.Conclusion The levels of serum leptin,NT-proBNP in patients with anthracycline-based chemotherapy were increased as the treatment prolonged.The correlations between serum leptin,NT-proBNP and LVEF may paly a vital role in the diagnosis of anthracycline-induced cardiotoxicity.