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目的:寻找胸部肿瘤放疗心脏受照时,早期发现心肌损伤的血清标志物,以利于尽早预防和治疗放疗并发症和后遗症。方法:30例胸部肿瘤患者为观察组,30例非胸部肿瘤者为对照组;分别采用普通放疗,2Gy/d,5次/周,前后对穿照射达40Gy后,所有患者分别在放疗前、放疗剂量达40Gy、放疗结束(60Gy～70Gy)时和放疗后1个月检测cTnI。结果:血清cTnI浓度>0.4ng/ml为诊断心肌损伤的界限值。放疗前与DT40Gy时cTnI含量轻度升高,P<0.05,差异有显著性;放疗前与放疗结束时比较显著升高,P<0.01,有极非常显著的统计学意义;放疗前与放疗后1个月的比较,P<0.001;放疗DT40Gy与放疗结束时比较,P<0.001,有非常显著的统计学意义;放疗结束时与放疗后1个月的比较,P>0.05,无统计学意义。结论:血清中cTnI的变化可早期反映放射性心脏损伤,以利于尽早预防和治疗放疗并发症和后遗症。
OBJECTIVE: To find the serum markers of myocardial damage in the early stage of chest cancer radiotherapy for cardiac irradiation in order to prevent as soon as possible the prevention and treatment of radiotherapy complications and sequelae. Methods: Thirty patients with thoracic tumor were selected as observation group and 30 patients with non-thoracic tumor as control group. All patients were treated with general radiotherapy, 2Gy / d for 5 times / week, and 40Gy for irradiation. Before and after radiotherapy, Radiotherapy dose of 40Gy, end of radiotherapy (60Gy ~ 70Gy) and 1 month after radiotherapy cTnI. Results: Serum cTnI concentration> 0.4ng / ml was the threshold for diagnosis of myocardial injury. Pretreatment with DT40Gy cTnI slightly increased, P <0.05, the difference was significant; before radiotherapy and radiotherapy at the end of a significant increase, P <0.01, very very significant statistical significance; before radiotherapy and after radiotherapy 1 month, P <0.001; radiotherapy DT40Gy and radiotherapy at the end of the comparison, P <0.001, a very significant statistically significant; at the end of radiotherapy and 1 month after radiotherapy, P> 0.05, no statistically significant . Conclusion: The change of serum cTnI can early reflect the radioactive cardiac injury, which can be used to prevent and treat radiotherapy complications and sequelae as soon as possible.