摘要
目的应用心肌定量组织速度成像(quantitative tissue velocity imaging,QTVI)技术评价表阿霉素不同给药方法化疗后左心功能的变化,评价其监测表阿霉素不同给药方法对心脏早期毒性作用的价值。方法选择病理确诊的乳腺癌46例、淋巴瘤19例,共65例,根据不同给药方法分为两组,微量泵入组31例,静脉输注组34例;表阿霉素剂量相同(70mg/m2);每周期治疗前后对心肌节段在心动周期中的QTVI等参数进行定量分析;同时测量左心室舒张末期内径(LVIDd)和室间隔舒张末期厚度(IVSTd)、左室后壁舒张末期厚度(LVPWTd)、左心室收缩末期内径(LVIDs)、计算左室射血分数(LVEF);用脉冲多普勒检测心尖四腔切面二尖瓣口血流频谱,测定舒张早期左室充盈峰值速度(E)和心房收缩期左室充盈峰值速度(A)的比值,即E/A等参数。结果微量泵入组及静脉输注组中各个化疗周期后LVIDd、IVSTd、LVPWTd、E/A、LVEF均无变化(与T0相比较,P>0.05)。微量泵入组完成四周期化疗(表阿霉素剂量280/m2)后出现舒张早期峰值运动速度(Ve)下降、舒张晚期峰值运动速度(Va)升高、Ve/Va下降;静脉输注组完成三周期化疗(表阿霉素剂量210/m2)后QTVI即出现上述变化。结论应用QTVI监测表阿霉素对心脏早期毒性作用是有效的,且表阿霉素微量泵入较静脉输注能减轻心脏的毒性。
Objective To evaluate the toxicity and side-effects of Epirubicin to heart from micro-pump and from intravenous drip medication using the method of the quantitative tissue velocity（QTVI） of the myocardium. Methods Sixty-five cases are chosen for the study, with 46 cases diagnosed as breast cancer and 19 of malignant lyrnphoma. The cases were divided into two groups： Micro-pump （MP） group （n = 31） and Intravenous Drip （ID）group （n = 34）, and all of them are given the same dosage of Epirubicin （70 mg/m^2）. Quantitative analyses of QTVI parameters are made before and after each chemotherapy of the myocardial segmentation in each cardiac cycle. In addition, measurements were also made of the left ventricular internal diameter at end-diastole （LVIDd）, the interventricular septal thickness at end- diastole （IVSTd）, the left ventricular posterior wall thickness at end- diastole （LVPWTd）, and left ventricular internal diameter at end-systole （LVIDs） ; and the left ventricular ejection fraction （LVEF） was also calculated. Meanwhile, pulsed Doppler ultrasound was employed to measure the cardiac venous flow of the mitral valve area in the apical four chamber view, the peak velocity of blood flow when the left ventrieular was at its early diastole （E） and that of the left ventricular at its early systole （A）, namely the ratio of E/A. Results Compared with T0 （P〉0. 05）, no differences are observed in the LVIDd, IVSTd, LVP- WTd, E/A ratio and LVEF between the MP and ID group at the end of each chemotherapy. But after four courses of chemotherapy with an Epirubicin dosage of 280/m^2, the velocity of early diastolic （Ve） begins to slow down in the MP group while the velocity of atrial contraction （Va） increases. As a result, the Ve/Va ratio falls in the MPG group. In contrast, at the end of the third chemotherapy with an Epirubicin dosage of 210/m^2 , the QTVI yields the same results in the ID group. Conclusion The application of QTVI in monitoring the toxicity and side-effects of Epirubicin to the heart is effective. Compared with the observations in the ID group, Epirubicin administrated in the MP group tends to lessen the toxicity and side-effects to the heart in chemotherapy.
出处
《肿瘤防治研究》
CAS
CSCD
北大核心
2010年第3期342-345,351,共5页
Cancer Research on Prevention and Treatment
基金
云南省教育厅科学研究基金资助项目(08Y0217)
关键词
定量组织速度成像
表阿霉素
心脏功能
Quantitative tissue velocity imaging
Epirubicin
Cardiac function
