文章摘要
杨洁,金朝龙.二维斑点追踪技术在早期评估乳腺癌病人蒽环类药物化疗导致右室心肌收缩功能减退中的价值[J].安徽医药,2024,28(5):953-956.
二维斑点追踪技术在早期评估乳腺癌病人蒽环类药物化疗导致右室心肌收缩功能减退中的价值
The value of two-dimensional speckle tracking technique in early assessment of right ventricular myocardial systolic dysfunction in patients with breast cancer caused by anthracycline chemotherapy
  
DOI:10.3969/j.issn.1009-6469.2024.05.022
中文关键词: 超声心动描记术  心肌收缩  蒽环类  二维斑点追踪技术  三维超声心动图
英文关键词: Echocardiography  Myocardial contraction  Anthracyclines  Two-dimensional speckle tracking  Three-dimensional echocardiography
基金项目:
作者单位
杨洁 国药中铁中心医院功能科安徽合肥 230011 
金朝龙 安徽医科大学第一附属医院心脏影像中心安徽合肥 230022 
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中文摘要:
      目的探讨二维斑点追踪技术在早期评估乳腺癌病人蒽环类药物化疗导致右室心肌收缩功能减退中的价值。方法选取 2019年 1月至 2022年 1月于安徽医科大学第一附属医院就诊的乳腺癌病人 50例,化疗方案以蒽环类药物为主。于化疗前和化疗第 2、4、6个周期后进行超声心动图检查,采集聚焦右心室心尖四腔心切面,测量右心室舒张末期内径(RVEDD)右心室舒张末期面积( RVEDA)、右心室收缩末期面积( RVESA)、右室舒张期末期容积( RVEDV)、右室收缩期末容积( RVESV)、、三尖瓣环收缩期位移( TAPSE)、右室面积变化分数( RVFAC)、右室射血分数( RVEF)、应用二维斑点追踪技术测量右心室整体纵向收缩期峰值应变值( RVGLS)。结果 50例病人各化疗阶段 RVEDD、RVEDA、RVESA、RVEDV、RVESV比较,差异均无统计学意义( P>0.05)。随着化疗时间的延长, 50例病人 TAPSE、RVFAC、RVGLS、RVEF均出现不同程度降低,其中 RVGLS在化疗第 4个周期( .18.50±2.33)%开始明显下降,差异有统计学意义( P<0.05)TAPSE、RVFAC在化疗第 6个周期( 17.21±2.15)mm、(38.12±4.92)%开始明显下降,差异有统计学意义( P<0.05)RVEF在四间点上差异无统计学意义( P>0.05)。结论二维个时,斑点追踪技术测量 RVGLS能反映乳腺癌病人化疗过程中右心,室心肌收缩功能的变化,与其他参数相比, RVGLS对右心室心肌收缩功能减退更为敏感,为早期评估右心室心肌收缩功能减退提供可靠的量化指标。
英文摘要:
      Objective To explore the value of two-dimensional speckle tracking technique in early assessment of right ventricularmyocardial systolic dysfunction in patients with breast cancer caused by anthracycline chemotherapy.Methods Fifty breast cancer pa-tients were treated in The First Affiliated Hospital of Anhui Medical University from January 2019 to January 2022. The chemotherapyregimen based on anthracyclines was used. Echocardiography was performed before chemotherapy and after the second, fourth andsixth chemotherapy cycles to collect the right ventricular apical four-chamber cardiac view, and measure right ventricular end-diastolic diameter (RVEDD), right ventricular end-diastolic area (RVEDA), right ventricular end-systolic area (RVESA), right ventricular end-di-astolic volume (RVEDV), right ventricular end-systolic volume (RVESV), tricuspid annular plane systolic excursion (TAPSE), right ven-tricular fractional area change (RVFAC), and right ventricular ejection fraction (RVEF). Two-dimensional speckle tracking technique was used to measure right ventricular global longitudinal strain (RVGLS).Results There were no statistically significant differences inRVEDD, RVEDA, RVESA, RVEDV and RVESV among 50 patients at each chemotherapy stage (P>0.05). With the extension of che-motherapy, TAPSE, RVFAC, RVGLS and RVEF of 50 patients decreased to different degrees, and RVGLS decreased significantly fromthe fourth cycle of chemotherapy [(.18.50±2.33) %] (P<0.05). TAPSE and RVFAC decreased significantly from the sixth cycle of che-motherapy [(17.21±2.15) mm, (38.12±4.92) %] (P<0.05). Although RVEF gradually decreased at four time points, the difference was not statistically significant (P>0.05).Conclusions Measurement of RVGLS by two-dimensional speckle tracking technique can reflectthe changes of right ventricular myocardial systolic function in breast cancer patients during chemotherapy.Compared with other param-eters, RVGLS is more sensitive to right ventricular systolic dysfunction, which can provide a reliable quantitative index for early assess-ment of right ventricular systolic dysfunction.
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