缺血修饰白蛋白检测对多柔比星心肌毒性诊断价值的探讨

目的:探讨缺血修饰白蛋白(IMA)对多柔比星导致急性心肌毒性反应早期诊断的临床意义,对多柔比星导致急性心肌毒性反应患者作出早期诊断及预测.方法:根据临床表现、心电图、患者IMA和肌钙蛋白T(cTnT)血清结果,将106例用多柔比星治疗的患者血清分为发病人群发病时血清(A组)、发病人群给药24 h后血清(B组)、高危人群给药24 h后血清(C组)及未发病人群给药24 h后血清(D组)4组血清,对4组中的血液指标检验结果升高例数进行组内及组间x2检验,比较其中差异；并对106例多柔比星诱发的急性心肌毒性患者的515份心电图与515份血清中的IMA指标升高例数进行相关性分析.结果:多柔比星急性心肌毒性反应患者发病时血清与正常人群血清IMA升高例数差异有统计学意义,x2 =30.94,P=0.00.多柔比星心肌毒性反应患者在用药24 h后与正常人群血清中IMA及cTnT升高例数差异有统计学意义(x2=36.43,P=0.00;x2=128.23,P=0.00).106例患者的515份异常心电图与515份血清中的IMA值异常例数进行相关性分析,结果提示发生急性心肌毒性反应患者中IMA的升高与心电图之间存在着相关性,r=0.783,P＜0.05.结论:多柔比星急性心肌毒性反应患者的IMA血液检验指标的异常提示,IMA检测对诊断多柔比星心肌毒性反应存在一定价值.

Investigation of Ischemia-modified albumin testing on the diagnosis of myocardial toxicity myocardial toxic induced by adriamycin

OBJECTIVE:To investigate the clinical significance of ischemia-modified albumin testing on the early diagnosis of acute myocardial toxicity patients induced by Doxorubicin.METHODS:Totally 106patients treated by Doxorubicin were selected,who were divided into disease group(group A),disease group after giving drugs 24hours(group B),high-risk group after giving drugs 24hours(group C) and no disease group after giving drugs 24hours(group D) according to the clinical manifestations and ECG and cardiac troponin T(cTnT).χ 2 was tested between two groups or in groups for the case of all increased blood parameters.And correlation between 515ECGs and 515 IMA-increasing cases of acute myocardial toxicity patient was analyzed.RESULTS:The increased numbers of IMA blood parameters have statistically significant differences and no statistically significant differences in cTnT blood parameters between the patient group with the normal group(χ 2 =30.94,P=0.00).The increased numbers of IMA and cTnT blood parameters have statistically significant differences between the patient group after given drugs 24hours with the normal group(χ 2 = 36.43,P=0.00;χ 2 =128.23,P=0.00).Totally 515abnormal electrocardiograms correlated with 515abnormal IMA blood parameters in 106acute myocardial toxicity patients induced by Doxorubicin(r=0.783,P<0.05).CONCLUSION:Abnormal results of ischemia modified albumin in patients with acute myocardial toxicity induced by Doxorubicin suggest that ischemia modified albumin testing is contributed to the diagnosis of acute myocardial toxicity induced by Doxorubicin.