保健医学研究与实践2024，Vol.21Issue(12)：57-63,7.DOI:10.11986/j.issn.1673-873X.2024.12.10
化疗前心脏代谢指数对乳腺癌患者化疗心脏毒性的预测价值
Predictive value of cardiac metabolic index before chemotherapy for cardiac toxicity of chemotherapy in patients with breast cancer
摘要
Abstract
Objective To explore the predictive value of cardiac metabolic index(CMI)before chemotherapy for cardiac toxic-ity of chemotherapy in patients with breast cancer.Methods 281 cases of breast cancer who received anthracycline chemo-therapy drugs after surgery in our hospital from June 2022 to December 2023 were selected as the study group,and 200 healthy person underwent physical examination selected as control group.According to the cardiac toxicity of chemotherapy,281 patients with breast cancer were divided into two subgroups:non cardiac toxicity group(n=213)and cardiac toxicity group(n=68).Blood lipid levels were measured by biochemical analyzer,triglyceride(TG),high-density lipoprotein cho-lesterol(HDL-C),waist circumference(WC)and height were recorded,and cardiometabolic index values were calculated.The predictive value of CMI for cardiotoxicity in breast cancer patients after chemotherapy was analyzed by ROC.Single fac-tor and multi factor logistic regression analysis to explore the influencing factors of cardiac toxicity in patients with breast cancer after chemotherapy.Results TG and CMI in study group were higher than control group,HDL-C was lower than control group(P<0.05).TG and CMI in cardiotoxicity group were significantly higher than those in non-cardiotoxicity group,HDL-C was significantly lower than that in non-cardiotoxicity group(P<0.05).The AUC predicted by TG and HDL-C for chemotherapy cardiotoxicity in breast cancer patients was 0.724(95%CI:0.679-0.774),0.847(95%CI:0.802-0.897),and the AUC predicted by CMI was 0.925(95%CI:0.880-0.975);BNP level of patients with breast cancer in cardiotoxic group was higher than that in non cardiotoxic group,and LVEF was lower than that in non cardiotoxic group(all P<0.05);Multivariate regression analysis showed that BNP≥39.73 pg/ml(OR=2.168,95%CI:1.250-3.761),LVEF<48.10%(OR=2.368,95%CI:1.320-4.246),TG≥2.59 mmol/L(OR=2.846,95%CI:1.559-5.195),HDL-C<1.24 mmol/L(OR=2.606,95%CI:1.523-4.460),and CMI≥1.06(OR=3.452,95%CI:2.054-5.803)are risk factors for cardiac toxicity of chemotherapy in breast cancer patients(P<0.05).Conclusion The high ex-pression of CMI before chemotherapy is a factor influencing the cardiotoxicity of chemotherapy for breast cancer,which can be used to predict the occurrence of cardiotoxicity in breast cancer patients after chemotherapy.关键词
乳腺癌/心脏代谢指数/化疗/心脏毒性/预测价值Key words
Breast cancer/Cardiometabolic index/Chemotherapy/Cardiotoxicity/Predictive value分类
医药卫生引用本文复制引用
向辉,贾晓斌,柯贤锋,王曦煜,李强,雷珍珍,文小强..化疗前心脏代谢指数对乳腺癌患者化疗心脏毒性的预测价值[J].保健医学研究与实践,2024,21(12):57-63,7.基金项目
陕西省卫生健康科研基金项目(2018C006). （2018C006）
