Changes Of NT-proBNP And CK-MB In Peripheral Blood Of Children With Anthracycline-induced Cardiotoxicity And Its Clinical Significance

Objective:To investigate the changes and clinical significance of N-terminal B-type natriuretic peptide precursor(NT proBNP)and creatine kinase isozyme(CK-MB)in peripheral blood of children with cardiotoxicity caused by acute leukemia(AL)treated with anthracyclines.Methods:72 children with acute leukemia who received anthracycline chemotherapy were collected.The levels of NT proBNP and CK-MB in peripheral blood circulation and left ventricular ejection fraction were measured before chemotherapy,when the cumulative dose of anthracycline(calculated by daunorubicin)was 120mg/m~2,when the cumulative dose of anthracycline(calculated by daunorubicin)was 240mg/m~2,LVEF).According to the occurrence of cardiotoxicity,the children were divided into two groups:heart damage group(n=20)and non heart damage group(n=52).The ROC curve was used to analyze the value of NT proBNP and CK-MB in predicting cardiotoxicity during chemotherapy.Results:The level of NT proBNP in peripheral blood of children with cardiotoxicity after chemotherapy was significantly higher than that before chemotherapy(P<0.01).However,there was no significant difference in the level of CK-MB between the heart damage group and the non heart damage group.At the same time,NT proBNP had a negative correlation with LVEF(r=-0.655,P<0.01).It could not be considered that there was a correlation between CK-MB and LVEF(r=-0.178,P=0.135).ROC curve was used to evaluate the value of NT proBNP and CK-MB in predicting cardiotoxicity.AUC and 95%CI under the curve were 0.990(0.971-1.000)and0.564(0.407-0.722),respectively.Conclusion:NT proBNP expression level in children with cardiotoxicity caused by anthracycline chemotherapy is significantly increased,which is an important marker for early prediction of cardiotoxicity caused by anthracycline chemotherapy in children with acute leukemia.However,the value of CK-MB in predicting the occurrence of cardiotoxicity has not been proved.