Abstract：【Objective】To explore the influencing factors of chronic cardiotoxicity in patients with malignant tumors treated with anthracycline chemotherapy. 【Methods】The clinical data of 64 patients with malignant tumors treated with anthracyclines in two hospital were collected. According to whether the patients had chronic cardiotoxicity within 1 year of chemotherapy, they were divided into toxic group (25 cases) and non-toxic group (39 cases). The baseline data, ECG abnormalities, cardiac troponin I (cTnI), creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH) levels of patients in the two groups were compared. The influencing factors of chronic cardiotoxicity in patients were analyzed by using receiver operating characteristic (ROC) curve and multivariate logistic regression. 【Results】The levels of cTnI, CK-MB and LDH in the toxic group were higher than those in the non-toxic group, and the incidence of ECG abnormalities in the toxic group was higher than that in the non-toxic group (P<0.05). ROC analysis showed that cTnI, CK-MB and LDH could be used to evaluate the occurrence of chronic cardiotoxicity in patients, and the areas under the curve were 0.746, 0.889 and 0.785, respectively (P<0.05). Multivariate logistic regression analysis confirmed that cTnI>84.430 ng/mL, CK-MB>28.692 IU/L, LDH>203.292 IU/L, ST-T segment changes, T wave abnormalities, sinusachycardia, atrioventricular block were the risk factors of chronic cardiotoxicity (P<0.05).【Conclusion】 cTnI>84.430 ng/mL, ST-T segment changes, CK-MB>28.692 IU/L, LDH>203.292 IU/L, T wave abnormalities, sinus tachycardia, atrioventricular block are the risk factors of chronic cardiotoxicity in patients treated with anthracycline chemotherapy, which can provide a reliable reference for early clinical intervention.
[1] SUNYOUNG L,EUN J L,AH J H, et al.O-RADS US: A systematic review and meta-analysis of category-specific malignancy rates[J].Radiology,2023,308(2):223-227. [2] 阎仲珩,黎志峰,路伟,等.DRG背景下某医院恶性肿瘤放化疗ICD编码问题分析[J].中国医院,2023,27(8):102-104. [3] TAKESHI O,YU K,BÉNÉDICTE L, et al.Impact of atrial fibrillation on heart failure in patients treated with anthracycline chemotherapy[J].Am J Card,2023,15(211):268-274. [4] MASAYUKI K,SUSUMU O,KIMIKAZU T, et al.Effect of increase in heart rate after anthracycline chemotherapy on subsequent left ventricular dysfunction[J].J Card,2023,9(23):S0914. [5] RODRIGUES AG, SALES ARK, FARIA D, et al.Sympathetic neural overdrive and diminished exercise capacity in reduced ejection fraction heart failure related to anthracycline- based chemotherapy[J].Am J Physiol Heart Circulatory Physiol,2023,325(5):H1126-H1132. [6] 胡炯. 未确定侵袭性真菌病的诊断和治疗:血液病/恶性肿瘤患者侵袭性真菌病的诊断标准和治疗原则解读[J].中华内科杂志,2017,56(6):395-397. [7] SHENGNAN L,YUE S,QIANG L, et al.Three-dimensional speckle-tracking echocardiography to evaluate left ventricular function of patients with breast cancer after anthracycline chemotherapy.[J].Alternat Ther Health Med,2023,29(7):388-393. [8] 曹培,张志清. 基于代谢组学的抗癌药物心脏毒性研究状况[J].中国临床药理学杂志,2023,39(5):752-756. [9] 侯西栋,周丽华,温艳艳. 蒽环类化疗药物致乳腺癌患者发生急性心脏毒性的危险因素研究[J].国际医药卫生导报,2024,30(1):103-108. [10] HENRIKSEN P A, HALL P, MACPHERSON I R, et al.Multicenter, prospective, randomized controlled trial of high-sensitivity cardiac troponin i-guided combination angiotensin receptor blockade and beta-blocker therapy to prevent anthracycline cardiotoxicity: the cardiac CARE trial[J].Circulation,2023,148(21):1680-1690. [11] ALDO C,MARIA D C,MARTINA Z, et al.High-sensitivity cardiac troponin I and T methods for the early detection of myocardial injury in patients on chemotherapy[J].Clin Chemist Iaborat Med,2020,59(3):513-521. [12] 王莉,徐敏芝,伍勇. 蒽环类药物的心肌损害和心电图表现[J].生物医学工程与临床,2022,26(5):607-612. [13] 许小芳,柴姣,朱卫伟. 蒽环类药物化疗对乳腺癌术后患者血清心肌、氧化应激标志物及心脏彩超指标的影响及相关性[J].癌症进展,2021,19(2):167-170. [14] 牛雅妮,马佳瑞,谢萍. 蒽环类药物致淋巴瘤患者心电图异常的危险因素分析[J].中国现代医药杂志,2022,24(10):5-9.
2024, Vol. 41 
