| 摘要: |
| 摘要：目的：应用超声心动图技术评价蒽环类药物（ATC）对右室功能的影响。方法：41例（LVEF≥55%）采用多柔比星脂质体为主的PAD方案化疗的多发性骨髓瘤患者，分别于化疗2、4、6周期后行经胸二维超声心动图检查，获得常规、组织多普勒及二维应变参数，20例健康者作为对照。结果：RVGLS在化疗各周期均低于对照组且随化疗周期延长不断减低，病例组在各周期E/Em均高于对照组，TAPSE在化疗6周期后明显减低；RVGLS与药物累积剂量呈显著负相关(r =-0.799,P =0.000），E/Em在ROC曲线下的面积为0.995（P =0.000），以5.22为截断值,敏感性为 93.7%,特异性为100%。结论：超声心动图可用于临床评估ATC化疗患者右室功能，RVGLS、E/Em、TAPSE可更好的早期评价右室功能变化。 |
| 关键词: 蒽环类药物 右室 化疗 二维斑点追踪技术 Tei指数 |
| DOI： |
| 投稿时间：2019-02-05修订日期：2019-02-05 |
| 基金项目: |
|
| Evaluating the effect of anthracycline on right ventricle function by echocardiography |
| zhangxiaoli,lufang |
| (Shanxi Medical University;Ultrasound department of the second hospital of Shanxi Medical University) |
| Abstract: |
| 【ＡBSTRACT】 Objective To explore the value of echocardiography in evaluating the effect of anthracycline on function of patients with multiple myeloma. Methods A total of 41 patients(LVEF≥55％) with multiple myeloma who received ATC treatment were enrolled．Each patient underwent transthoracic echocardiographic examination before chemotherapy as well as after two,four and six cycles of ATC remedy．Right ventricular(RV)end—diastolic area(EDA), end—systolic area(ESA),and early or late diastolic myocardial velocities of RV were calculated, Tissue Doppler imaging(TDI) measurements of systolic , early or late diastolic myocardial velocities of RV free wall at tricuspid annuals，E/Em,tricuspid annular plane systolic excursion(TAPSE),and Tei index of right or left ventricle were also analyzed．Two-dimensional speckle tracking echocardiography(2DSTE) was conducted to evaluate RV global longitudinal strain(GLS) , 20 cases of healthy volunteers were selected as the normal. Results The RVGLS and E/Em changed significantly after cures of treatment compared with those at baseline(P<0．05)，The RVGLS were decreased as the chemotherapy cycle．At the end of the therapy after six cycles of ATC treatment, TAPSE decreased significantly till six cures of treatment compared with those at baseline(P<0.05)，The RVGLS were negatively correlated to cumulative anthracycline dose,the correlation coefficient were -0.799,respectively (P <0.001). The area under the ROC curve of E/Em was 0.995(P = 0.000),If 5.22 was selected as the diagnosis cut-off point,the sensitivity was 93.7%,and the specificity was 100%.Conclusion RVGLS,E/Em and TAPSE are more sensitive indetecting abnormalities of right ventricular function． |
| Key words: Anthracycline right ventricle therapy Two-dimensional speckle tracking echocardiography Tei index |
