急性白血病患者化疗相关心脏毒性及检测方法分析

摘要

Objective To research cardiomyopathy induced by chemotherapeutics ( DNR and Arsenious acid ) in patients with acute leukemia and its detection methods. Methods Eighty - eight acute leukemia patients, admitted from June 2010 to April 2011, were given conventional chemotherapy. 12 - lead electrocardiogram ( EGG ), myocardial enzymes and changes of plasma NT - proBNP level were observed before, after chemotherapy. Results EGG changed obviously and plasma NT -proBNP elevated in 8 patients after chemotherapy ( P < 0. 05 ), but there was not significant difference in myocardial enzymes ( P >0. 05 ). Plasma NT - proBNP elevated in most patients ( P <0. 05 ), but no significant difference in myocardial enzumes ( P > 0. 05 ). Conclusion EGG is a conventional detection method for chemotherapy - induced cardiomyopathy, NT - proBNP can be used as a simple and practical monitoring tools.%目的 研究急性白血病常用化疗药物(柔红霉素和亚砷酸)引起相关心脏毒性及监测方法.方法 对2010年6月-2011年4月在河北省廊坊市中医医院收治的88例初治急性白血病患者进行常规药物化疗,并监测化疗前后12导联心电图(ECG)、心肌酶谱及血浆N末端脑钠肽前体(NT-proBNP)水平变化.结果 共8例患者出现明显ECG改变,且化疗后血浆NT-proBNP均升高,差异有统计学意义(P＜0.05);而心肌酶谱变化差异无统计学意义(P＞0.05).88例患者中大部分患者化疗后血浆NT-proBNP升高,差异有统计学意义(P＜0.05);心肌酶谱变化差异无统计学意义(P＞0.05).结论 对于急性白血病患者应用柔红霉素及亚砷酸常规药物治疗可能引起相关的心脏毒性,ECG是常规检测手段,NT-proBNP亦可作为简便实用的监测手段.