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心房钠尿肽(atrial natriuretic peptide,ANP)、N端-前ANP(NT-pro ANP)和脑钠尿肽(BNP)属于结构相关的肽家族,为过度负荷的心房或心室所合成、贮存和分泌。作者运用这三种不同的心脏钠尿肽血浆水平的系列测定,前瞻性监测接受包含阿霉素的联合化疗方案(CHOP)的恶性淋巴瘤患者亚临床左室机能异常。28例初治成人非霍奇金淋巴瘤(NHL),原先未接受蒽环类抗生素或纵隔放射治疗,无心衰病史。按照国际预后指标分为低危3例,低-中危5例,高-中危11例,高危9例。15例(54％)为弥漫性大细胞淋巴瘤。CHOP方案中阿霉素(H)的剂量为50mg/m~2(每3周一次)。左室射血分数(LVEF)<45％时停用阿霉素。基础状态和每次治疗前及末次CHOP方案后4周抽血查钠尿肽,均采用放射免疫测定。健康成人的正常值分别为ANP10.9±3.98pmol/L,BNP 6.25±2.12pmol/L,NT-proANP 227±84pmol/L,>平均值±2标准差为异常。
Atrial natriuretic peptide (ANP), N-terminal-pre-ANP (NT-pro ANP), and brain natriuretic peptide (BNP) belong to a family of structurally related peptides that are synthesized and stored by overloaded atria or ventricles. secretion. The authors used a series of three different plasma concentrations of cardiac natriuretic peptides to prospectively monitor subclinical left ventricular dysfunction in patients with malignant lymphoma receiving a doxorubicin-containing combined chemotherapy regimen (CHOP). 28 untreated adult non-Hodgkin’s lymphomas (NHL) had not previously received anthracycline antibiotics or mediastinal radiation therapy and had no history of heart failure. According to international prognostic indicators, there were 3 cases of low risk, 5 cases of low-to-moderate risk, 11 cases of high-to-moderate risk, and 9 cases of high-risk. Fifteen patients (54%) were diffuse large cell lymphoma. The doxorubicin (H) dose in the CHOP regimen was 50 mg/m 2 (once every 3 weeks). Doxorubicin was discontinued when left ventricular ejection fraction (LVEF) was < 45%. The basal state and blood test for natriuretic peptides were performed before treatment and 4 weeks after the last CHOP regimen. Radioimmunoassay was used. The normal values for healthy adults were ANP 10.9 ± 3.98 pmol/L, BNP 6.25 ± 2.12 pmol/L, NT-proANP 227 ± 84 pmol/L, and the mean ± 2 standard deviations were abnormal.