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高敏肌钙蛋白T作为确定非霍奇金淋巴瘤患者阿霉素方案心脏毒性的补充手段

High Sensitivity Troponin T as Complementary Modality for Determining Doxorubicin Regimen Cardiotoxicity in Non-Hodgkin Lymphoma Patients.

作者信息

Prayogo Ami Ashariati, Suryantoro Satriyo Dwi, Savitri Merlyna, Hendrata Winona May, Wijaya Andi Yasmin, Pikir Budi Susetyo

机构信息

Division of Hematology-Oncology, Department of Internal Medicine, Dr. Soetomo Teaching Hospital, Surabaya, East Java, Indonesia.

Department of Internal Medicine, Airlangga University Hospital, Surabaya, East Java, Indonesia.

出版信息

Adv Pharm Bull. 2022 Jan;12(1):163-168. doi: 10.34172/apb.2022.017. Epub 2020 Oct 19.

Abstract

This study aims to evaluate the role of high-sensitivity troponin T (hsTnT) as a complementary tool for determining cardiotoxicity in non-Hodgkin lymphoma (NHL) patients receiving cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) regimen chemotherapy. We included 35 patients diagnosed with NHL who received CHOP chemotherapy. Left ventricular ejection fraction (LVEF) and hsTnT were measured at two time points: before the first cycle (pre-test) and after the fourth cycle (post-test). The LVEF and hsTnT were analysed using IBM SPSS version 24 through the paired-sample T-test, Wilcoxon signed-rank test, Pearson's correlation and Spearman's correlation. There was a significant difference in both LVEF and hsTnT between pre-chemotherapy and post-4th chemotherapy cycles ( = 0.001). However, more contrast difference from the baseline value of hsTnT compared to LVEF could be observed. LVEF did not detect any deterioration in myocardial function. However, 10 out of 35 subjects exhibit hsTnT higher than the 99th percentile of the population (>14 pg/ml), suggesting that myocardial injury (MI) could be detected. There was no correlation between LVEF and hsTnT ( > 0.05). HsTnT, together with LVEF, could complement each other and offer better coverage for detecting cardiotoxicity during the administration of CHOP in NHL patients. An insignificant correlation between hsTnT and LVEF showed that cardiotoxicity existed in a broad spectrum including cellular damage and functional impairment, as hsTnT represents cellular damage, and LVEF reflects heart functional capacity.

摘要

本研究旨在评估高敏肌钙蛋白T(hsTnT)作为一种辅助工具在确定接受环磷酰胺、阿霉素、长春新碱和泼尼松(CHOP)方案化疗的非霍奇金淋巴瘤(NHL)患者心脏毒性中的作用。我们纳入了35例诊断为NHL且接受CHOP化疗的患者。在两个时间点测量左心室射血分数(LVEF)和hsTnT:第一个周期前(测试前)和第四个周期后(测试后)。使用IBM SPSS 24版通过配对样本t检验、Wilcoxon符号秩检验、Pearson相关性和Spearman相关性对LVEF和hsTnT进行分析。化疗前和第4次化疗周期后LVEF和hsTnT均存在显著差异(P = 0.001)。然而,与LVEF相比,hsTnT与基线值的差异更明显。LVEF未检测到心肌功能有任何恶化。然而,35名受试者中有10名的hsTnT高于人群第99百分位数(>14 pg/ml),表明可检测到心肌损伤(MI)。LVEF与hsTnT之间无相关性(P>0.05)。HsTnT与LVEF可相互补充,在NHL患者接受CHOP治疗期间能更好地覆盖心脏毒性检测。hsTnT与LVEF之间无显著相关性表明心脏毒性存在于包括细胞损伤和功能损害的广泛范围内,因为hsTnT代表细胞损伤,而LVEF反映心脏功能能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdcb/9012930/b1170223c1ca/apb-12-163-g001.jpg

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