二维应变超声心动图评价乳腺癌患者表阿霉素化疗后左心室收缩功能  

Evaluation of left ventricular regional systolic function in breast cancer patients after Epirubicin chemotherapy with two-dimensional strain echocardiography

作　　者：毕小军[1] 邓又斌[1] 曾繁静[1] 朱英[1] 伍玉晗[1] 赵策瑶[1] 黎春雷[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院超声影像科,湖北武汉430030

出　　处：《中国医学影像技术》2009年第8期1415-1418,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨二维应变超声心动图在评价乳腺癌术后患者表阿霉素化疗左心室心内膜下心肌局部收缩功能的价值。方法116例乳腺癌患者分为3组:A组38例,给予表阿霉素总剂量120～340mg/m2;B组42例,给予表阿霉素总剂量≥360mg/m2;C组36例,为尚未进行化疗患者,作为对照组。对三组患者分别进行常规超声测量并记录左心室心尖长轴切面、心尖两腔切面及心尖四腔切面的高帧频二维图像,应用二维应变超声分析软件测量左心室心尖位心内膜下心肌收缩期峰值应变。结果A、B、C三组常规超声心动图各参数之间差异无统计学意义(P>0.05)。A组与C组相比,除前间隔基底段、侧壁心尖段、后壁及下壁中间段、心尖段和后间隔心尖段外,左心室心尖位各节段心内膜下心肌峰值收缩期应变出现减低,差异有统计学意义(P<0.05);B组各节段心内膜下心肌峰值收缩期应变较C组出现明显减低,差异有统计学意义(P<0.05),与A组相比除前间隔基底段、中间段,后壁基底段,下壁基底段、中间段、心尖段及后间隔中间段外,应变在部分节段有所减低,差异有统计学意义(P<0.05)。结论二维应变超声心动图能够早期监测表阿霉素化疗后左心室心内膜下心肌局部收缩功能。Objective To assess left ventricular regional systolic function in breast cancer patients after Epirubiein （Epi） chemotherapy with two-dimensional strain echocardiography. Methods A total of 116 breast cancer patients were divided into three groups： group A, 38 patients were given Epi of 120- 340 mg/m^2 ; group B, 42 patients were given Epi of 360 mg/m^2 ; group C, 36 patients after surgical operation without chemotherapy served as the control group. High frame rate two-dimensional images were recorded from apical long-axis view, four-chamber view and two-chamber view of left ven- tricle. Peak systolic strain of left ventricular subendocardial myocardial was measured with two-dimensional strain software, the conventional ecbocardiographic parameters were also obtained. Results There was no significant variation of conventional echocardiographic parameters between any two groups （P〉0.05）. Compared with the controls, the peak systolic strain of left ventricular subendocardial myocardial reduced in some segments in group A and B （P〈0.05）. In group B, the peak systolic strain of left ventricular subendocardial myocardial reduced just in some of the segments compared with group A （P〈 0.05）. Conclusion Two-dimensional strain echocardiography has its value for early monitoring the Epirubiein-induced eardiotoxicity.

关 键 词：乳腺肿瘤 心室功能 左 表阿霉素 超声心动描记术 应变 

分 类 号：R737.9[医药卫生—肿瘤] R540.45[医药卫生—临床医学]