血浆糖原磷酸化酶同功酶BB、肌红蛋白和B型尿钠肽水平预测化疗药物致心脏毒性对临床护理的指导价值

Value of plasma glycogen phosphorylase isoenzyme BB,myoglobin,and brain natriuretic peptide levels in predicting cardiotoxicity by chemotherapy drugs on clinical care

目的探讨血浆糖原磷酸化酶同功酶BB(GPBB)、肌红蛋白(Mb)和B型尿钠肽(BNP)水平与非霍奇金淋巴瘤(NHL)化疗药物致心脏毒性的关联性,指导临床护理及时监测和干预。方法选取NHL患者106例,分为心脏毒性组(25例)和心脏正常组(81例)。检测化疗前后患者的血浆GPBB、Mb、BNP水平,并对数据进行处理和分析。结果化疗全疗程结束后,心脏毒性组和心脏正常组的GPBB、Mb和BNP水平均高于其化疗前水平,心脏毒性组血浆GPBB、Mb和BNP水平均明显高于心脏正常组,差异均有统计学意义(P<0.05);血浆GPBB、Mb和BNP水平诊断化疗药物致心脏毒性的受试者工作特征曲线下面积(AUC)为0.85、0.78和0.79。血浆GPBB、Mb和BNP联合诊断化疗药物致心脏毒性的AUC最高(0.91)。结论血清GPBB、Mb和BNP浓度检测可作为NHL化疗药物致心脏毒性的早期诊断指标,其检测结果对临床护理具有指导价值。

Objective To investigate the association of plasma glycogen phosphorylase isoenzyme BB（GPBB）,myoglobin（Mb） and B-type natriuretic peptide（BNP） levels with the cardiotoxicity caused by non-Hodgkin’s lymph Tumor（NHL）chemotherapy drugs,so as to guide the timely monitoring of clinical care and intervention. Methods 106 patients with NHL were recruited and divided into cardiotoxicity group（n = 25） and normal heart group（n = 81）. Plasma GPBB,Mb and BNP levels were measured before and after chemotherapy,and the data were processed and analyzed. Results The levels of GPBB,Mb and BNP in the cardiotoxic group and the normal group were higher than those before chemotherapy,and the levels of GPBB,Mb and BNP in the cardiotoxicity group were significantly higher than those in the control group,with the differences statistically significant（P 〈 0. 05）; area under the working characteristic curve（AUC） of plasma GPBB,Mb and BNP levels were respectively 0. 85,0. 78 and 0. 79 in patients with cardiotoxicity induced by chemotherapy. AUC of plasma GPBB,Mb and BNP combined with diagnostic agents for cardiomyoxectin challenge was the highest（0. 91）. Conclusion The serum GPBB,Mb and BNP concentrations can be used as early diagnostic index for cardiotoxicity induced by chemotherapy drugs in NHL. The results are valuable for clinical nursing.