| 摘要: |
| 目的 本研究采用二维斑点追踪显像技术（2D-STI）评价使用蒽环类化疗药物患者左室收缩功能及左室收缩同步性，探讨2D-STI在评价蒽环类药物化疗早期心肌毒性中的应用价值。方法 选取我院诊断为乳腺癌的女性患者40例，所有患者均接受表柔比星化疗。分别在化疗前（T0）、第一周期及第二周期化疗后（T1、T2）进行二维超声心动图检查，用EchoPAC软件分析蒽环类药物化疗患者左室心肌内膜、心肌外膜、整体纵向应变（EndoGLS、EpiGLS、GLS）、环向应变（EndoGCS、EpiGCS、GCS）及左室整体径向应变（GRS）；获取纵向、环向及径向整体达峰时间标准差（Tssl-SD、Tssc-SD，Tssr-SD）及纵向、环向及径向达峰时间最大差值（Tssl-Dif、Tssc-Dif、Tssr-Dif），获取纵向、环向及径向延迟指数（LSDI、CSDI、RSDI）。结果 与T0周期相比，GLS、endoGLS及endoGCS在T2周期化疗后的变化有统计学意义（p2均＜0.05）；与T0周期相比，患者Tssl-SD及LSDI 在T2周期化疗后的变化有统计学意义（p2均＜0.05）。结论 2D-STI技术获取的分层应变参数及同步性参数可以准确分析蒽环类药物化疗患者早期心肌收缩功能的损伤及室壁运动协调性的损伤，能够敏感发现蒽环类药物化疗后的早期心肌毒性表现。 |
| 关键词: 超声心动描记术 乳腺癌 蒽环类药物化疗 二维斑点追踪显像 左心室功能 不同步性 |
| DOI： |
| 投稿时间：2018-05-02修订日期：2018-06-19 |
| 基金项目: |
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| Early evaluation of cardiotoxicity using two-dimensional speckle tracking layer-specific imaging in patients with anthracycline chemotherapy |
| tanya,郭瑞强 |
| () |
| Abstract: |
| Objective To evaluate left ventricular (LV) systolic function and LV dyssynchrony in patients with
anthracycline chemotherapy by two-dimensional speckle tracking imaging (2D-STI) for the investigation of the value of 2D-STI in early diagnosis of myocardial toxicity with anthracycline chemotherapy. Methods 40 patients diagnosed with breast cancer and epirubicin chemotherapy were prospectively enrolled. The strain parameters by EchoPAC analysis software included global longitudinal strain (GLS), GLS of endocardial and epicardial layers (endoGLS and epiGLS) and global circumferential strain (GCS), GCS of endocardial and epicardial layers（endoGCS and epiGCS), global radial strain (GRS) at baseline (T0), after the first cycle (T1) and after the second cycle (T2) of chemotherapy. At the same time, the time of the 18 segments to maximal systolic longitudinal, circumferential, radial strain (Tssl, Tssc, Tssr) were measured. The longitudinal, circumferential, radial segmental standard deviation (Tssl-SD, Tssc-SD, Tssr-SD) and the maximal difference of Tssl, Tssc, Tssr (Tssl-Dif, Tssc-Dif, Tssr-Dif) were calculated; the sum of the difference between the longitudinal, radial and circumferential strain peaks and the final strain of the 18 segments was measured, which is longitudinal, radial and circumferential strain delay indices (LSDI, CSDI, RSDI). Results GLS, endoGLS, endoGCS at T2 were significantly lower than those in T0 (p2＜0.05, all).while Tssl-SD and LSDI in T2 were significantly increased comparing to those in T0 (p2＜0.05, all). Conclusions With accurate assessment of endoGLS and Tssl-SD for the analysis of LV global systolic function and dyssyncrony, the myocardial toxicity at early stage can be detected sensitively by 2D-STI in patients with anthracycline chemotherapy. |
| Key words: Echocardiography Breast cancer Anthracycline chemotherapy Two-dimensional speckle tracking imaging Left ventricular Dyssynchrony |
