组织多普勒评价胸部放疗患者的右心功能  

Assessment of right ventricle function by chest radiotherapy with tissue Doppler imaging

作　　者：姜志荣[1] 李大海[2] 张小花[1] 

机构地区：[1]山东青岛大学医学院附属医院心脏超声科,青岛266003 [2]河北大学附属医院超声科

出　　处：《临床超声医学杂志》2007年第8期470-473,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨常规超声心动图和组织多普勒(TDI)技术在评价胸部放疗对右心功能影响的临床应用价值。方法将120例患者按是否联合化疗及化疗剂种类分为单纯放疗组(Ⅰ),放疗联合蒽环类化疗组(Ⅱ),放疗联合其他化疗剂组(Ⅲ)。测定并比较120例胸部肿瘤患者放疗前、放疗后6个月的常规超声心动图参数及TDI参数。健康志愿者29例作平行对照。结果放疗后TDI显示右房室瓣瓣环及右室游离壁的收缩期运动速度峰值、心室舒张早期运动速度峰值比放疗前降低,而心房收缩期运动速度峰值升高,以放疗联合蒽环类化疗组改变最明显。传统超声心动图显示仅有12例(10%)患者放疗后出现右室舒张功能常规指标异常。结论TDI技术较常规超声心动图能更早、更敏感地评价放疗导致的右心功能损害;放疗联合应用化疗可加重心脏损害,尤以联合蒽环类化疗为重。Objective To explore the clinical value of echocardiography and tissue Doppler imaging in assessing right ventricle function damage induced by chest radiotherapy in patients with thoracic tumors. Methods One hundred and twenty patients （ the patients were divided into three groups： Ⅰ group： radiotherapy simply; Ⅱ group： radiotherapy combined with anthracychnes; Ⅲgroup： radiotherapy combined with other chemotherapeutic drugs. ） received chest radiotherapy were examined by echocardiography and tissue Doppler imaging before radiotherapy and six months later. Twenty nine healthy person were enrolled as control group. Results Parameters of TDI showed： after radiotherapy, the peak motion velocity of tricuspid annulus and right ventricle free wall during systolic period and early diastolic period decreased , while the peak velocity during atrial systole period increased. Among patients received radiotherapy combined with anthracyclines treatment, the changes of parameters acquired from TDI differed significantly from those patients treated by simplex irradiation or radiotherapy combined with other chemotherapeutic drugs. At the same time, those data in patients received radiotherapy combined with other chemotherapeutic drugs differed significantly from those patients treated by simplex irradiation. Parameters of left ventricle systolic function index had no statistic significance compared with those data acquired before irradiation, While abnormalities of routine diastolic function index of right ventricle appeared in 12 patients（ 10% ） and increase of pulmonary artery systolic pressure appeared in 2 patients. As to the control group, all of the parameters changed insignificantly six month later. Conclusion Echocardiography and TDI can be used in assessing early right ventricle function damage induced by chest radiotherapy. Compared with echocardiography, TDI is more sensitive in detecting abnormalities of heart function. Radiotherapy combined with anthracyclines or other chemotherapeutic drugs c

关 键 词：超声心动描记术 多普勒 组织 放射疗法 心室功能 右 

分 类 号：R542.2[医药卫生—心血管疾病]