血脑钠肽及肌钙蛋白I水平与胸部放疗后放射性心脏损伤发生率的关系-东南大学学报医学版

血脑钠肽及肌钙蛋白I水平与胸部放疗后放射性心脏损伤发生率的关系

单位：承德医学院附属医院肿瘤科, 河北承德 067000

分类号：R818.023;R730.55

出版年·卷·期（页码）：2018·37·第四期（682-686）

摘要：

目的：探讨胸部恶性肿瘤放射治疗患者血清脑钠肽（BNP）和肌钙蛋白I（cTn I）水平与放射性心脏损伤（RIHD）发生的相关性。方法：对60例胸部恶性肿瘤患者采用三维适形放疗；放疗前、放疗6周和放疗3个月检测血清cTn I和BNP水平。结果：RIHD 43例（71.7%），1级RIHD 40例，2级RIHD 3例；心电图异常22例中17例于放疗结束后即出现异常，5例于放疗3个月后出现异常。患者血清BNP和cTn I水平在放疗第6周发生显著上升，放疗后3个月回落，放疗第6周BNP和cTn I水平均显著高于放疗前和放疗后3个月（P<0.05）；放疗第6周RIHD组cTn I和BNP水平均显著高于无RIHD组（P<0.05），与放疗前比较RIHD组BNP显著上升（P<0.05）。结论：RIHD患者血清BNP和cTn I水平在放疗早期显著升高，两者可作为潜在早期预测指标。

Objective:To study the correlation between serum cTn I, BNP and radiation-indaced heart diseases (RIHD) in patients with chest malignant tumor radiotherapy. Methods:Three dimensional conformal radiotherapy was used in 60 patients with malignant tumor in chest. The serum levels of cTn I and BNP were detected before radiotherapy, 6 weeks of radiotherapy and 3 months of radiotherapy. Results:There were 43 cases of RIHD (71.7%), in which 40 cases was grade 1, 3 cases was grade 2. There were 22 cases of abnormal electrocardiogram, 17 cases happened after radiotherapy, 5 cases happened after 3 months of radiotherapy. The serum cTn I and BNP in the sixth week of radiotherapy rose significantly, then decreased 3 months after radiotherapy, cTn I and BNP six weeks after radiotherapy were significantly higher than that of 3 months before and after radiotherapy (P< 0.05); having in the RIHD group radiotherapy for sixth weeks BNP and cTn I were significantly higher than that of non RIHD group; compared with RIHD group before radiotherapy, BNP increased significantly (P< 0.05). Conclusion:The plasma levels of BNP and cTn I in patients with RIHD are significantly increased at the early stage of radiotherapy. BNP and cTn I could be used as a potential early predictor.

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