The Diagnostic Value Of NT-proBNP、cTnI And IMA On Daunomycin Induced Cardiotoxicity In Children With Acute

BackgroundDaunorubicin has been becoming to the first-line drug of acute childhood leukemia because of its strong anti-tumor effect. It makes a significant contribution in improving the remission rate and long-term survival. But the clinical application is seriously impacted by its cardiotoxicity. There is no safe dose of daunorubicin. It would produce cardiotoxicity even if we use a little doses. So we must detect the cardiotoxicity of DNR earlier. There are many methods to detect the cardiac function, but how to select the appropriate indicators to achieve detection and intervention earlier is very important.ObjectiveThis study is designed to investigate the diagnostic value of NT-proBNP, cTnI and IMA on daunorubicin-induced cardiotoxicity in acute childhood leukemia, to find the diagnostic indicators for the early intervention and to provide the security for the children who had used daunorubicin.MethodsWe use the enzyme-linked immunosorbent assay (ELISA) to detect the concentration of NT-proBNP, IMA and use the microparticle enzyme immunoassay (MEIA) to detect the concentration of cTnI before using DNR and using the dose of DNR reached 90mg/m2,150mg/m2,240mg/m2,300mg/m2,and analyze the diagnostic value.ResultsThe children number is respectively 60,60,49,38 and 17 before using DNR and using the dose of DNR reached 90mg/m2,150mg/m2,240mg/m2,300mg/m2.The concentration of IMA is respectively 36.01±3.08、36.62±2.60、58.73±20.53 67.37±22.57、78.60±23.10(U/ml).There is significant difference among groups(F=58.128,P=0.000). Comparing two groups each other, it has no significant difference (P>0.05) between the group of before using DNR and the group of 90mg/m2,but it has significant difference comparing with other groups (.P=0.000).The concentration of cTnI is respectively 0.0060±0.0042,0.0073±0.0043.0.0078±0.0045、 0.4058±1.2195、1.3405±3.9286(ug/L),it has significant difference between groups (F= 7.717, P=0.000). Comparing two groups each other, it also shows significant difference between the group of before using DNR and the group of 240mg/m2 (P=0.041),and the same as comparing the group of 300mg/m2 with other groups (P=0.000).The concentration of NT-proBNP is respectively 81.40±60.65、82.74±66.75、96.74±86.72、 211.60±197.21、381.93±215.52(pg/ml),it has significant difference among groups(F =5.084, P=0.001). Comparing two groups each other, it also has significant difference between the group of 240mg/m2 and the group of before using DNR (P<0.01),and the same as comparing the group of 300mg/m2 with the group of 240mg/m2(P<0.05),and with other groups(P<0.01).Conclusion1.IMA can be used as an early diagnostic indicator on daunorubicin-induced cardiotoxicity; cTnl can be used as a specific diagnostic indicator on daunorubicin-induced cardiotoxicity; NT-proBNP can be used as a sensitive indicator of heart failure.2. We will know cardiotoxicity at different levels by monitoring the indicators of NT-proBNP, cTnl and IMA.