摘要
目的探讨组织多普勒成像技术(TDI)对弥漫大B细胞淋巴瘤(DLBCL)患者R-CHOP方案多次化疗后左心室舒张功能的定量评估。方法纳入60例经病理确诊为DLBCL、并接受R-CHOP方案多次化疗的患者,分别于化疗前(T0)、第1~6次化疗(记为T1~T6)后进行常规心脏超声检查,所有参数均测量3次取平均值,收集室间隔厚度(IVSd)、左心室收缩末期内径(LVESd)、左心室舒张末期后壁厚度(LVPWd)、左心室舒张末期内径(LVEDd)、左心室射血分数(LVEF)、二尖瓣舒张早期速度峰值(E)及舒张晚期速度峰值(A),E/A值;进入TDI模式,取得室间隔e’、侧壁e’、室间隔E/e’、侧壁E/e’及平均E/e’,比较7次左心室常规心脏超声参数与左心室TDI参数差异。结果60例患者T0~T6阶段IVSd、LVEDd、LVPWd、LVESd、LVEF参数比较,差异均无统计学意义(F分别=0.95、0.58、1.23、0.86、2.15,P均>0.05),但T0~T6时,患者E峰、A峰、E/A值呈下降趋势,差异均有统计学意义(F分别=9.65、2.75、4.02,P均<0.05)。T0~T6阶段的室间隔e'、侧壁e'及平均e'呈逐步下降趋势,室间隔E/e'、侧壁E/e'、平均E/e'呈逐步上升趋势,差异均有统计学意义(F分别=37.60、50.24、49.35、2.41、2.60、2.61,P均<0.05)。结论R-CHOP方案多次化疗后DLBCL患者左心室舒张功能下降,TDI技术可用于监测R-CHOP方案化疗后早期左心室舒张功能障碍。
Objective To investigate the quantitative assessment of left ventricular diastolic function after multiple che⁃motherapy with R-CHOP regimen in patients with diffuse large B-cell lymphoma(DLBCL)by tissue Doppler imaging(TDI).Methods Sixty patients with pathologically confirmed DLBCL and receiving multiple chemotherapy with the R-CHOP regimen were included,and routine cardiac ultrasonography was performed before(T0)and after the 1st(T1),2nd(T2),3rd(T3),4th(T4),5th(T5),and 6th(T6)chemotherapy sessions,respectively.All parameters were measured three times.The ventricular septal thickness(IVSd),left ventricular end-systolic internal diameter(LVESd),left ven⁃tricular posterior wall thickness(LVPWd),left ventricular end-diastolic internal diameter(LVEDd),left ventricular ejection fraction(LVEF),peak mitral valve early diastolic velocity(E)and peak late diastolic velocity(A),E/A val⁃ue,septal e',lateral wall e',septal E/e',lateral wall E/e'and mean E/e'were compared.Results There was no signifi⁃cant difference in IVSd,LVEDd,LVPWd,LVESd,and LVEF parameters from T0 to T6(F=0.95,0.58,1.23,0.86,2.15,P>0.05).However,the E peak,A peak,and E/A values showed a decreasing trend from T0 to T6(F=9.65,2.75,4.02,P<0.05).In terms of TDI,the septal e',lateral e',and mean e'values of the patients showed a gradual decreasing from T0 to T6,while the septal E/e'lateral wall E/e',mean E/e'showed the increasing trend(F=37.60,50.24,49.35,2.41,2.60,2.61,P<0.05).Conclusion Left ventricular diastolic function is decreased in DLBCL patients after multiple chemo⁃therapy with the R-CHOP regimen,and the TDI technique can be used to monitor early left ventricular diastolic dysfunc⁃tion after chemotherapy with the R-CHOP regimen.
作者
王金娇
戴丽雅
吕晴
毛玲玲
赵中伟
WANG Jinjiao;DAI Liya;LYV Qing(Department of Ultrasound,The Fifth Affiliated Hospital of Wenzhou Medical University,Lishui 323000,China)
出处
《全科医学临床与教育》
2023年第6期499-502,共4页
Clinical Education of General Practice
