缺血修饰清蛋白评价蒽环类药物致心肌损伤的临床分析

目的通过检测应用不同累积剂量蒽环类(anthracycline,ANT)药物化疗前后血液系统恶性肿瘤患者血清中缺血修饰清蛋白(ischemia-modified albumin,IMA)及心肌肌钙蛋白I(cardiac troponin I,cTnI)水平的变化,探讨IMA在评价ANT化疗药物引起患者心肌损伤的敏感程度中的作用。方法选取90例血液系统恶性肿瘤患者,根据蒽环类药物的累积剂量将其分为3组:A组(未化疗组);B组(0～450 mg/m2组);C组(450～800 mg/m2组);用清蛋白钴结合(albu-min cobalt binding,ACB)试验测定患者用药后IMA水平,应用日本Olympus公司的AU2700全自动生化分析仪检测cTnI水平。结果应用ANT化疗药物的患者IMA水平较未化疗组明显升高(P<0.01),应用高剂量ANT化疗药物(450～800mg/m2)的患者较应用低剂量ANT化疗药物(0～450 mg/m2)患者IMA水平明显升高(P<0.01)。结论 IMA可能是ANT化疗药物所致早期心肌损伤新的血清学标志物。

Clinical analysis on evaluation of anthracycline-induced myocardial injury by ischemia-modified albumin

Objective To investigate the role of serum ischemia-modified albumin(IMA) in evaluating the sensitive degree of anthracycline(ANT)-induced myocardial injury by detecting the change of IMA and cardiac troporin I(cTnI) levels in the patients with different hematological malignancies before and after chemotherapy by different cumulative doses of ANT.Methods 90 cases of hematological malignancies were selected and divided into 3 groups according to the cumulative doses of ANT,group A(non-chemotherapy group),group B(0-450 mg/m2 group) and group C(450-800 mg/m2 group).The albumin cabalt binding(ACB) test was used to measure the IMA level after treatment and Japanese Olympus AU2700 automatic biocheical analyzer was adopted to detect the cTnI level.Results The IMA level in the anthracycline chemotherapy patients was significantly higher than that in the non-chemotherapy group(P<0.01).The IMA level in the patients with high dose of ANT chemotherapy(450-800 mg/m2) was significantly higher than that in the patients with low dose of ANT chemotherapy(0-450 mg/m2)(P<0.01).Conclusion IMA may be a new serological marker of early anthracycline-induced myocardial injury.