Research On Cardiotoxicity Clinical Index Of Anthracyline

Objective To detect the creatine kinase-MB (CK-MB), cardiac troponin I (cTNI),brain natriuretic peptide (BNP) in peripheral blood, and electrocardiography(ECG),ultrasonic cardiogram (UCG) changes before and after ANT chemotherapy, then discussand evaluate the sensitive cardiotoxicity clinical index of ANT.Method80acute leukemia patients who were hospitalized in Soochow UniversityAffiliated Children’s Hospital were recruited for this study. They were divided into twogroup according accumulated dose of anthracycline (ANTH):21patients in Group≤100mg/m~2,59patients in Group＞100mg/m~2. Index changes before and after ANTchemotherapy were evaluated, SPSS16.0was used for correlation analysis.Results1. Relationship between ANTH and cTNI elevation(1)80cTNI results were detected,21patients in Group≤100mg/m~2,59patients inGroup＞100mg/m~2. Serum cTNI were all≤0.04ug/L before chenmotherapy.(2) Statistic on cTNI elevation cases of different ANTH:1case in Group≤100mg/m~2,15cases in Group＞100mg/m~2.(3) There were no differences of cTNI elevation between different ANTH（P=0.056, P＞0.05）.2. Relationship between ANTH and CK-MB elevation(1)77cTNI results were detected,18patients in Group≤100mg/m~2,59patients inGroup＞100mg/m~2.(2) Statistic on CK-MB elevation cases of different ANTH:1case in Group≤100mg/m~2,7cases in Group＞100mg/m~2.(3) There were no differences of CK-MB elevation between different ANTH（P=0.67,P＞0.05）. 3. Relationship between ANTH and BNP elevation(1)75BNP results were detected,18patients in Group≤100mg/m~2,57patients inGroup＞100mg/m~2.(2) BNP changes were detected before and after chemotherapy. In Group≤100mg/m~2, BNP were (27.3±7.52),(42.3±16.98) respectively; while in Group＞100mg/m~2, they were (29.7±8.06),(46.3±15.38) pg/mL.(3) There were significant differences of CK-MB elevation between different ANTH.（Group≤100mg/m~2: P=0.0016＜0.05，Group＞100mg/m~2: P=0.001＜0.05).4. Relationship of LVEF（Left ventricular ejection fraction）,LVFS(Left ventricularshortening fraction),LVEDD(Left ventricular end-diastolic dimension),LVESD (LeftVentricular End Systolic Diameter) before and after chenmotherapy(1)57UCGs were examed before and after chemotherapy,11patients in Group≤100mg/m~2,46patients in Group＞100mg/m~2.(2) Changes of LVEF、LVFS、LVEDD、LVESD before and after chemotherapy werecalculated.(3) There were no differences of LVFS、LVEDD、LVESD (P＞0.05). In Group≤100mg/m~2, LVEF showed no statistical differences before and after chemotherapy, whilethere were differences in Group＞100mg/m~2(P=0.039, P＜0.05).5. Correlation analysis of BNP changes and LVEF、LVFS.(1)57UCGs were examed before and after chemotherapy,11patients in Group≤100mg/m~2,46patients in Group＞100mg/m~2. Changes of BNP before and afterchemotherapy were detected.(2) SPSS16.0were used to study for relationship of BNP changes and LVEF、LVFSin each group.(3) There were no differences of BNP changes and LVFS in each group (P＞0.05).Conclusion1、CK-MB，cTNI elevate in several cases during the treatment of ANT，indicatingtheir clinical monitoring value.2、BNP rises in all ANTH treatment courses，which means it could act as an indicatorof cardiotoxicity in the treatment with ANT. 3、The fact that the change of EF correlates with ANTH hints that it could act as anearly stage indicator of ANTH.