摘要
目的:探讨二维斑点追踪成像技术(speckle tracking imaging,STI)在评价不同剂量蒽环类药物(anthracycline,ATC)对乳腺癌患者左心功能早期损害的价值。方法:62例乳腺癌患者,采用6周期以表柔比星为主的化疗方案,应用自身对照研究,分别于化疗前1 d及每周期化疗后的第3天,行常规超声测量及应用STI分析软件测量左室长轴基底段收缩期及舒张期应变率。结果:常规超声参数:第5、6周期表柔比星累积剂量分别达450 mg/m2、540 mg/m2时,E/A减低,与化疗前比较,差异有统计学意义(P<0.05)。STI指标:第3周期时表柔比星累积剂量达270 mg/m2,左室壁基底段舒张早期峰值应变率(SRe)、房缩期峰值应变率(SRa)开始减低(P<0.05);第5、6周期时SRe、SRa明显减低(P<0.01),收缩期峰值应变率(SRs)减低(P<0.05)。结论:在化疗进程中,STI指标较早出现异常,而常规超声参数则较晚出现异常,故STI能更敏感地评价ATC对乳腺癌患者心功能损害。
Abstract AIM： To assess the value of two-dimensional speckle tracking imaging （STI） in detecting early damage of left ventricular function in breast cancer patients treated with different doses of anthracy- cline. METHODS： Sixty-two female breast cancer patients were selected and were administered a six-cycle epirubicin-based chemotherapy. The systolic strain rate （SRs）, early diastolic strain rate （SRe） and later diastolic strain rate （SRa） of left ventricular basal segments and the parameters of con- ventional echocardiography were measured 1 day before and the third day after each chemotherapy session and a self-control study of the parameters was conducted. RESULTS： Conventional echocardiography showed that the cumulative dose at the fifth-cycle chemotherapy and the sixth-cycle chemotherapy was, respectively, 450 mg/m2 and 540 mg/m2, and E/A was significantly reduced compared with that before chemotherapy （P 〈 0. 05 ）. STI showed that at the third-cycle chemotherapy, the cumulative dose was 270 mg/m2 and SRe and SRa of left ventricular basal segments began to decrease （P 〈 0. 05 ）. SRe and SRa reduced significantly at the fifth-cycle chemotherapy and the sixth-cycle chemotherapy （ P 〈 0. 01 ） as well as the reduction of SRs （ P 〈 0. 05 ）. CONCLUSION ： During chemotherapy, SRI changes appear earlier than those of conventional echocardiography. Therefore, STI is more sensitive in detecting early damage of left ventricular function caused by anthracycline in breast cancer patients.
出处
《心脏杂志》
CAS
2014年第1期56-59,63,共5页
Chinese Heart Journal
