胸部肿瘤患者放疗时心肌肌钙蛋白I变化的研究

目的:寻找胸部肿瘤放疗心脏受照时,早期发现心肌损伤的血清标志物,以利于尽早预防和治疗放疗并发症和后遗症。方法:30例胸部肿瘤患者为观察组,30例非胸部肿瘤者为对照组;分别采用普通放疗,2Gy/d,5次/周,前后对穿照射达40Gy后,所有患者分别在放疗前、放疗剂量达40Gy、放疗结束(60Gy～70Gy)时和放疗后1个月检测cTnI。结果:血清cTnI浓度>0.4ng/ml为诊断心肌损伤的界限值。放疗前与DT40Gy时cTnI含量轻度升高,P<0.05,差异有显著性;放疗前与放疗结束时比较显著升高,P<0.01,有极非常显著的统计学意义;放疗前与放疗后1个月的比较,P<0.001;放疗DT40Gy与放疗结束时比较,P<0.001,有非常显著的统计学意义;放疗结束时与放疗后1个月的比较,P>0.05,无统计学意义。结论:血清中cTnI的变化可早期反映放射性心脏损伤,以利于尽早预防和治疗放疗并发症和后遗症。

Study on the Change of Cardiac Troponin I of Patients with Chest Tumor Under Radiotherapy

Objective To explore an early discovery of blood serum maker of myocardial damage when the heart was exposed for chest tumor radiotherapy, and to prevent and treat complications and residuals as soon as possible.Methods 30 patients with chest tumor were in observation group, and another 30 patients with non-chest tumor were in control group.The patients in the former group were put into ordinary radiotherapy of 2 Gy per day,5 times per week and cTnI of all patients were detected before radiotherapy, when 40 Gy of radiotherapy dose, after radiotherapy(60 Gy～70 Gy) and when a month after radiotherapy,respectively.Results It was defined that CTnI concentration of blood serum was greater than 0.4 ng/ml as the threshold value of myocardial damage diagnosis. There was a significant difference between the result before radiotherapy and that under 40 Gy of radiotherapy dose which was slightly high(P<0.05) and there was a statistical significant difference between the result before radiotherapy and that after radiotherapy which was high(P<0.01). Both the result before radiotherapy and that of one month after radiotherapy and the result under 40 Gy of radiotherapy dose and that after radiotherapy all appeared statistically significant(P<0.001), but no statistical significance was found when the result of one month after radiotherapy compared with that after radiotherapy(P>0.05).Conclusion The change of cTnI concentration in blood serum can discover radioactive myocardial damage of earlier period. It can help to prevent and treat complications and residuals for radiotherapy as soon as possible.