心型脂肪酸结合蛋白在蒽环类药物引起心肌损伤中的变化

Changes of Myocardial Damage Caused by Heart-type Fatty Acid Binding Protein in Anthracyclines

目的研究心型脂肪酸结合蛋白(H-FABP)在蒽环类药物化疗引起心肌损伤后的水平,探讨其对心肌损伤检测的意义。方法临床纳入80例我院2013年4月至2014年6月期间收治的淋巴瘤或乳腺癌患者作为研究对象,其中40例患者行蒽环类药物化疗作为研究1组,另40例患者由于各种原因未行化疗作为研究2组,另选取40例同期来我院进行体检的健康人作为对照组。观察3组对象心肌标志物水平以及H-FABP水平情况。结果 3组患者LVEF、cTnⅠ、BNP、HFABP、LDH、AST、CK以及CK-MB基线水平无差异,P>0.05;对照组及研究2组患者不同时段各指标无显著差异(P>0.05);研究1组患者化疗后1、2 w仅H-FABP水平有统计学差异(P<0.05),其他指标无统计学差异(P>0.05),而化疗后1~24个月,各项指标均有统计学差异(P<0.05)。结论 H-FABP水平在心肌损伤中具有重要检测意义,且相对于其他传统指标具有更早诊断价值,值得临床应用。

Objective To study the levels of myocardial damage caused by heart-type fatty acid binding protein （H-FABP） after anthracyclines-based chemotherapy, and discuss its significance for myocardial damage detection. Methods 80 clinical cases of lymphoma or breast cancer admitted and treated in our hospital from April 2013 to June 2014 were taken as the research objects. 40 of them given anthracyclines-based chemotherapy were taken as Group 1, and the rest 40 patients not given chemotherapy due to various reasons were taken as Group 2. Another 40 healthy cases who came to the hospital for medical examination in the corresponding period were taken as control group. Levels of myocardial markers and H-FABP of the three groups were observed. Results There was no difference in levels of LVEF, cTnI, BNP, H-FABP, LDH, AST, CK and CK-MB among patients in the three groups （ P〉0. 05）. There were no significant differences in indexes between the control group and Group 2 at different periods （P〉0. 05 ）, as for Group 1, there were statistical differences only in H-FABP level after chemotherapy for 1-2 weeks （P〈0. 05）. In the following 1 - 24 months after chemotherapy, there were statistical differences in each index （ P〈0. 05 ）. Conclusion H-FABP level has significant importance in the detection of myocardial damage and earlier diagnostic values compared with other traditional indexes, which is worthy of clinical application.