摘要
目的观察结直肠癌患者使用联合药物FOLFOX化疗前后左心室应变参数的变化。方法选取健康人30例作为正常组,收集病理确诊为结直肠癌并采用FOLFOX(5-氟尿嘧啶+奥沙利铂+亚叶酸钙)化疗的患者30例,以自身对照做研究,分别在化疗前、化疗1个周期后、化疗6个周期后、化疗12个周期后48 h内完成心脏超声检查,采集左心室的动态图像,获取常规参数:LVEDd、LVEDs、IVSd、LVPWd、LVEDV、LVESV、LVEF、LVFS;三维参数:SPI、SV、CO、LVEDMass、LVESMass、GAS、GRS、GLS、GCS,并比较化疗前后这些数值的变化。结果正常组与各化疗组相比对,LVEDd、LVEDs、IVSd、LVPWd、LVPW、LVESV、SPI的变化均无统计学意义(P>0.05);LVEF、LVFS、SV、CO在化疗中、后期出现了降低,差异有统计学意义(P<0.05),HR、LVEDMass、LVESMass略升高,差异有统计学意义(P<0.05);化疗后GLS及GAS较化疗前明显减低(P<0.05),其中GAS的ROC曲线下面积为0.883,P<0.001,选30%为诊断界点,灵敏度为86.7%,特异度为80%;GLS的ROC曲线下面积为0.888,P<0.001,选19%为诊断界点,灵敏度为73.3%,特异度为90.0%。结论三维斑点追踪技术能够早期发现FOLFOX致结直肠癌患者左心室功能的变化,其中LVGLS、LVGAS是有力的观测指标。
Objective To observe the changes of left ventricular strain parameters in patients with colorectal cancer before and after combined chemotherapy with FOLFOX.Methods 30 healthy people were selected as normal group,and 30 patients with pathologically diagnosed colorectal cancer and FOLFOX(5-fluorouracil+oxaliplatin+calcium leucovorin)chemotherapy were collected.Before,after 1 cycle of chemotherapy,after 6 cycles of chemotherapy,and within 48 hours after 12 cycles of chemotherapy,cardiac ultrasound examination was performed,and dynamic images of the left ventricle were collected to obtain conventional parameters:LVEDd,LVEDs,IVSd,LVPWd,LVEDV,LVESV,LVEF,LVFS;three-dimensional parameters:SPI,SV,CO,LVEDMass,LVESMass,GAS,GRS,GLS,GCS,and the changes of these values before and after chemotherapy were compared.Results Compared with the chemotherapy group,the normal group had no statistically significant changes in LVEDd,LVEDs,IVSd,LVPWd,LVPW,LVESV,and SPI(P>0.05);LVEF,LVFS,SV,CO were in the middle and late stages of chemotherapy.There was a decrease,the difference was statistically significant(P<0.05),HR,LVEDMass,LVEESMass were slightly increased,the difference was statistically significant(P<0.05);LGS and GAS after chemotherapy were significantly lower than before chemotherapy(P<0.05),the area under the ROC curve of GAS is 0.883,P=0.000,30%is selected as the diagnostic boundary,the sensitivity is 86.7%,and the specificity is 80%;the area under the ROC curve of GLS is 0.888,P=0.000,19%as a diagnostic boundary,the sensitivity is 73.3%and the specificity is 90.0%.Conclusion Three-dimensional speckle tracking technology can detect the changes of left ventricular function in patients with colorectal cancer caused by FOLFOX in early stage,of which LVLGS and LVGAS are powerful observation indicators.
作者
王臻
秦文娟
翟子敬
郭雪婷
王忠
芦桂林
WANG Zhen;QIN Wenjuan;ZHAI Zijing;GUO Xueting;WANG Zhong;LU Guilin(School of Medicine of Shihezi University,Shihezi 832008,China;Department of Ultrasonography,First Affiliated Hospital,School of Medicine,Shihezi University,Shihezi 832008,China;Department of Cardiology,First Affiliated Hospital,School of Medicine,Shihezi University,Shihezi 832008,China)
出处
《广州医药》
2021年第2期28-32,共5页
Guangzhou Medical Journal
基金
国家自然科学基金项目(81460075)。
