| 张利芳,郭泰,刘改珍,等.二尖瓣环位移自动追踪技术评价蒽环类药物对乳腺癌病人左室收缩功能的影响[J].安徽医药,2021,25(10):1949-1953. |
| 二尖瓣环位移自动追踪技术评价蒽环类药物对乳腺癌病人左室收缩功能的影响 |
| Impact evaluation of anthracycline on left ventricular systolic function in patients with breast cancer by tracking of mitral annular displacement |
| |
| DOI：10.3969/j.issn.1009-6469.2021.10.010 |
| 中文关键词: 超声心动描记术，多普勒，彩色 乳腺肿瘤 蒽环类药物 左室 二尖瓣环位移自动追踪技术 |
| 英文关键词: Echocardiography,doppler,color Breast neoplasms Anthracycline Left ventricle Tracking of mitral annular dis |
| 基金项目:山西省留学回国人员科技活动择优资助项目( 2060503-41) |
|
| 摘要点击次数: 1818 |
| 全文下载次数: 714 |
| 中文摘要: |
| 目的应用二尖瓣环位移自动追踪技术评价蒽环类药物对乳腺癌病人左室收缩功能的影响，探讨反映左室功能受损较为准确和敏感的参数。方法收集 2018年 10月至 2019年 12月于山西医科大学第二医院乳腺外科诊断为乳腺癌的女性病人 50例，均行以表柔比星为主的化疗方案，分别于化疗前、化疗 2及 4周期后，行常规超声心动图、二维斑点追踪技术( 2D-STI)及二尖瓣环位移自动追踪技术( TMAD)检查，获得左室射血分数( LVEF)、左室整体纵向峰值应变( LVGLS)及二尖瓣环连线中点最大位移与左心室舒张期末最大纵径比值( Mid%)。比较化疗前后以上各参数的差异。结果与化疗前比较，化疗 4周期后 LVEF降低，化疗前( 67.85±4.16)%，化疗 4周期后( 63.35±4.49)%；与化疗前比较，化疗 2、4周期后 LVGLS降低，化疗前(?22.78±1.93)%，化疗 2周期后(-18.85±1.02)%，化疗 4周期后( -16.97±1.07)%；与化疗前比较，化疗 2、4周期后 Mid%均值降低，化疗前( 17.52±0.96)mm，化疗 2周期后( 14.92±0.76)mm，化疗 4周期后( 12.99±0.98)mm；化疗前后各周期 Mid%均值与 LVEF呈弱相关( r=0.452，0.505，0.435，P<0.05)与 LVGLS呈强相关( r=0.815，0.802，0.857，P<0.05)； ROC曲线分析显示化疗 4周期后 LVGLS和 Mid%均值预测蒽环类药物毒性的 ROC曲线下面积分别为 0.962及 0.912；重复性检验结果显示 LVGLS和 Mid%均值的观察者内 ICC值分别为 0.885、0.912，观察者间 ICC值分别 0.841、0.900；LVEF、LVGLS及 Mid%均值与药物剂量均呈负相关( r=-0.398，-0.876，-0.906，P<0.05)。结论 TMAD技术可早期识别化疗病人左心室整体收缩功能障碍， Mid%均值较 LVGLS心脏，测量简便易行且重复性好，可作为敏感参数。 |
| 英文摘要: |
| Objective To evaluate the effect of anthracycline on left ventricular systolic function in patients with breast cancer using the tracking of mitral annular displacement technology (TMAD), and to explore the more accurate and sensitive parameters reflecting left ventricular dysfunction.Methods Fifty female patients, diagnosed with breast cancer in the Breast Surgery Department of Second Hospital of Shanxi Medical University from October 2018 to December 2019, received epirubicin-based chemotherapy. Routine echocardiography, two-dimensional speckle tracking imaging (2D-STI) and TMAD were performed before chemotherapy and after 2 and4 cycles of chemotherapy. Left ventricular ejection fraction (LVEF), left ventricular global longitudinal strain, and the ratio of the maximum displacement at the midpoint of the mitral annulus line to the maximum longitudinal diameter at the end of the left ventricular diastolic period (Mid%) were obtained. The differences of the above parameters before and after chemotherapy were compared.Results Compared with pre-chemotherapy, the LVEF was decreased after 4 cycles of chemotherapy [(67.85±4.16)% vs. (63.35±4.49)%], LVGLS decreased after 2 and 4 cycles of chemotherapy [(-22.78±1.93)% vs. (-18.85±1.02)%; (-22.78±1.93)% vs.(-16.97±1.07)%], the Mid% mean decreased after 2 and 4 cycles of chemotherapy [(17.52±0.96) mm vs. (14.92±0.76) mm; (17.52±0.96) mm vs. (12.99±0.98) mm]. There was a weak correlation between Mid% mean and LVEF (r=0.452, 0.505, 0.435, P<0.05), and a strong correlation with LVGLS (r= 0.815, 0.802, 0.857, P<0.05) before and after chemotherapy. ROC curve analysis showed that the areas under curves of LVGLS andMid% mean for predicting cardiotoxicity of anthracyclines were 0.962 and 0.912, respectively. The repeatability test showed that intraobserver ICC values of LVGLS and Mid% mean were 0.885 and 0.912 respectively, and the inter-observer ICC values were 0.841 and 0.900 respectively. LVEF, LVGLS and Mid% mean were negatively correlated with drug doses (r=-0.398, -0.876, -0.906, P<0.05).Con?clusions TMAD can identify early left ventricular global systolic dysfunction in patients undergoing chemotherapy. And the measure ment of Mid% mean is easier and more repetitive than LVGLS, which can be used as a sensitive parameter to evaluate left ventricular systolic function. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
