期刊文献+

二维斑点追踪超声心动图联合超敏心肌肌钙蛋白T检测早期诊断化疗药物引起的隐匿性心脏毒性 被引量:15

Early detection of the cardiotoxicity induced by chemotherapy drug through two-dimensional speckle tracking echocardiography combined with high-sensitive cardiac troponin T
原文传递
导出
摘要 目的 评价二维斑点追踪超声心动图(STE)联合超敏心肌肌钙蛋白T(hs-cTnT)检测早期诊断化疗药引起的隐匿性心脏毒性的价值.方法 75例弥漫大B细胞非霍奇金淋巴瘤(NHL)患者采用CHOP方案化疗,在化疗前、第3个疗程结束后的第2天(化疗中期)和最后1个疗程结束后的第2天(化疗后)进行常规超声和二维STE检查,测量左室整体纵向应变(LS)、环周应变(CS)和径向应变(RS).在STE检查的同期,测量左室射血分数(LVEF),并取血测定hs-cTnT.结果 75例NHL患者中,30例患者完成了3个疗程CHOP方案,45例患者完成了6-8个疗程CHOP方案.所有患者化疗前、化疗中期和化疗后的LVEF分别为(63.8±2.6)%、(63.8±2.8)%和(64.0±3.3)%,差异无统计学意义(P=0.91).75例患者化疗前、化疗中期和化疗后的左室整体LS分别为(-18.5±1.7)%、(-16.5±1.9)%和(-16.0±1.6)%,左室整体 CS分别为(-20.9±2.9)%、(-19.3±3.5)%和(-19.2± 3.2)%,左室整体RS分别为(39.2±6.4)%、(35.3±5.2)%和(35.0±6.2)%,hs-cTnT分别为(0.0010± 0.0020)ng/ml、(0.0063±0.0089)ng/ml和(0.0073±0.0038)ng/ml,化疗中期的左室整体LS、CS和RS均较化疗前显著下降,hs-cTnT较化疗前显著升高,差异均有统计学意义(均P〈0.01),而化疗后的左室整体LS、CS、RS和hs-cTnT与化疗中期差异无统计学意义(均P〉0.05).化疗前、化疗中期和化疗后的17节段LS达峰时间标准差(TLS-SD)、12节段CS达峰时间标准差(TCS-SD)和12节段RS达峰时间标准差(TRS-SD)差异无统计学意义(均P〉0.05).化疗后左室LS降低率与hs-cTnT升高呈正相关(r=0.60,P〈0.01).结论 二维STE联合hs-cTnT可有效、准确地评估蒽环类药物化疗过程中的隐匿性心脏毒性. Objective To investigate the clinical value of two-dimensional speckle tracking echocardiography(2D-STE)combined with high-sensitive cardiac troponin T(hs-cTnT)in early detection of the cardiotoxicity induced by chemotherapy drug. Methods Seventy-five non-Hodgkin′s lymphoma patients who received the CHOP regimen were recruited in this study. Conventional echocardiography and 2D-STE were performed on these patients before chemotherapy,the second day after the third course of chemotherapy (during chemotherapy)and the second day after the last course of chemotherapy(after chemotherapy). The parameters included left ventricular ejection fraction(LVEF), global longitudinal strain(LS), global circumferential strain(CS)and global radial strain(RS). The serum hs-cTNT levels were tested simultaneously. Results Three cycles of CHOP were completed in 30 patients and 6-8 cycles of CHOP were completed in 45 patients. The LVEF of 75 patients before, during and after chemotherapy was(63.8 ± 2.6)%,(63.8 ± 2.8)% and(64.0 ± 3.3)%, respectively, without significant difference(P= 0.91). However,the LS of 75 patients before, during and after chemotherapy was(-18.5 ± 1.7)%,(-16.5 ± 1.9)% and(-16.0±1.6)%,respectively. The CS was(-20.9±2.9)%,(-19.3±3.5)% and(-19.2± 3.2)%,respectively. The RS was(39.2±6.4)%,(35.3±5.2)% and(35.0±6.2)%,respectively. The hs-cTnT was(0.001 0 ± 0.002 0)ng/ml,(0.006 3 ± 0.008 9)ng/ml and(0.007 3 ± 0.003 8)ng/ml, respectively. The LS, CS and RS were significantly decreased while hs-cTnT was significantly increased during chemotherapy when compared to those before chemotherapy(all of P〈0.01). Alternatively, the LS, CS,RS and hs-cTnT after chemotherapy were marginally different from those during chemotherapy(all of P〉0.05). Moreover, TLS-SD, TCS-SDand TRS-SDshowed no significant difference before, during and after chemotherapy(all of P〉0.05). The reduction of LS was positively associated with the enhancement of hs-cTnT after chemotherapy(r=0.60,P〈0.01). Conclusion 2D-STE combined with hs-cTnT can effectively and precisely detect the occult cardiotoxicity induced by anthracycline.
出处 《中华肿瘤杂志》 CAS CSCD 北大核心 2017年第11期835-840,共6页 Chinese Journal of Oncology
基金 国家自然科学基金青年项目(81401411) 上海自然科学基金青年项目(14zr1425200)
关键词 淋巴瘤 化疗药物 心脏毒性 二维斑点追踪超声心动图 超敏心肌肌钙蛋白T Lymphoma Chemotherapy drug Cardiotoxicity Two-dimensional speckle tracking echocardiography High-sensitive cardiac troponin T
  • 相关文献

参考文献4

二级参考文献57

  • 1张明岩,安晶红,柴淼,潘宇,袁国明.阿霉素在临床应用中心脏毒性的研究进展[J].哈尔滨医药,2008,28(5):55-56. 被引量:6
  • 2江泽飞,宋三泰.蒽环类化疗药物治疗乳腺癌的新动向[J].中华肿瘤杂志,2005,27(4):193-195. 被引量:27
  • 3徐兵河,赵龙妹,王佳玉,袁芃.泰索帝联合顺铂治疗31例蒽环类耐药性晚期乳腺癌疗效分析[J].中华肿瘤杂志,2006,28(6):471-473. 被引量:46
  • 4Pinder MC,Ouan Z,GoodwinJS,et al.Congestive heart failure in older womentreated with adjuvant anthracycline chemotherapy for breast cancer.J Clin Oncol, 2007,25 (25) :3808-3815.
  • 5Chargari C, Kirov KM, Bollet MA, et al.Cardiac toxicity in breast cancer patients: From a fractional point of view to a global assessment. Can Treat Rev ,2011,37(4) :321-330.
  • 6Villani F, Meazza R, Materazzo C. Non - invasive monitoring of cardiachemodynamic parameters in doxoruhicin -treated patients: comparison with echocardiography.Anticancer Res, 2006 , 26 (1): 797-801.
  • 7Elbl L, Vasova I, Kral Z, et aI.Echocardiographic evaluation of early and chronic cardiotoxicity in adult patientstreated for Hodgkin's disease with ABVO regimen .Neoplasma,2006,53( 1) :62-66.
  • 8Gennari A, Sormani MP, Pronzato P, et al.HER2 status and efficacy of adjuvant anthracyclines in early breast cancer: a pooled analysis of randomized trials.J Nat! Cancer Inst,2008, 100( 1) : 14-20.
  • 9Baur LH.Strain and strain rate imaging: a promising tool for evaluation of ventricular function.lntJ Cardiovasc Imaging, 2008, 24( 5) : 493 -494.
  • 10Oi Salvo G, Pacileo G, Limongelli G, et al. Abnormal regional myocar?dial deformation properties and increased aortic stiffness in normoten?sive patients with aortic coarctation despite successful correction: an ABPM ,standard chocardiography and strain rate imaging study.Clin Sci(Lond) ,2007,113(5) :259-266.

共引文献58

同被引文献96

引证文献15

二级引证文献57

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部