【摘要】 目的观察柔红霉素(DNR)化疗后急性白血病(AL)患儿血浆脑钠素(BNP)水平及心脏功能指标改变,以探讨BNP水平变化早期评价DNR对心脏功能影响的意义。方法选择急性淋巴细胞性白血病(ALL)患儿,应用DNR+长春新碱+左旋门冬酰胺酶+泼尼松(DVLP)方案诱导化疗31例,应用DNR前后采用酶联免疫吸附试验(ELISA)测定其血浆BNP水平,采用彩色多普勒超声测定左心室舒张末期直径(LVEDD),常规检测化疗前后心电图(ECG)及心肌酶谱(LDH1、CK-MB)。结果ALL患儿应用DNR化疗后血浆BNP水平从(3.97±2.41)ng/L升高至(18.25±7.63)ng/L(P<0.01)。LVEDD也从(50.1±1.9)mm增加至(53.9±2.3)mm(P<0.05)。BNP水平升高和LVEDD增加呈正相关(r=0.61 P=0.005)。而ECG、心肌酶谱治疗前后均无显著改变。结论血浆BNP水平可作为早期监测DNR对ALL患儿心脏功能影响指标之一。更多还原

【Abstract】 Objective To explore the clinical significance of the brain natriuretic peptide(BNP) in evaluating the cardiotoxicity caused by daunorubicin(DNR) through studying the changes of the plasma BNP levels in children with acute leukemia who accepted the chemotherapy with DNR.Methods Thirty-one children with acute lymphoblastic leukemia(ALL) admitted in the year of 2002-2004 underwent the chemotherapy in DVLP project.The plasma level of BNP was measured by enzyme linked immunosorbent assay(ELISA) and the left ventricular end diastolic diameter(LVEDD) by color Doppler respectively before and after the administration of DNR.Simultaneously,electrocardiography(ECG) and cardiac muscle enzymes(LDH1,CK-MB) were measured as routine.Results The plasma level of BNP increased from(3.97±2.41) ng/L to(18.25±7.63) ng/L(P<0.01) and the LVEDD increased from(50.1±1.9) mm to(53.9±2.3) mm(P<0.05).There was a positive correlation between BNP concentration and LVEDD increase(r=0.61).However,ECG and cardiac muscle enzymes(LDH1,CK-MB) remained normal.Conclusion The plasma level of BNP may be a sensitive marker in early evaluating the heart function during the chemotherapy with DNR.更多还原