乳腺癌患者表阿霉素心脏毒性的组织多普勒超声评价  

Tissue Doppler echocardiography evaluatec cardiac toxicity by epirubicin in breast cancer

作　　者：林纪光[1] 林道浙[2] 寿仕新[1] 王朋会[1] 董海霞 陈激[1] 

机构地区：[1]浙江省瑞安市人民医院超声影像科,浙江瑞安325200 [2]瑞安市人民医院肿瘤综合治疗中心,浙江瑞安325200

出　　处：《医学影像学杂志》2010年第3期359-361,共3页Journal of Medical Imaging

基　　金：浙江省瑞安市科技局立项课题(编号:20082111)

摘　　要：目的:探讨组织多普勒超声心动图评估乳腺癌患者表阿霉素心脏毒性的临床应用价值。方法:47例接受表阿霉素化疗的女性乳腺癌患者,表阿霉素总累积量450mg/m2,开始化疗前及每个疗程结束后进行心脏超声检查并测量相关参数,健康对照组20例。常规超声心动图指标选取左室舒张末内径(LVDd),左室射血分数(LVIEF)、二尖瓣口舒张早期血流速度E峰与舒张晚期血流速度A峰比值;组织多普勒超声心动图指标有二尖瓣环左室侧壁收缩期峰值速度s’峰,及朝向心房侧的负向舒张早期波e’峰与舒张晚期波a’峰比值(e’/a’)。结果:与开始化疗前相比,常规超声心动图指标LVIDd、LVEF在累积量达到450mg/m2才出现显著差别,舒张功能指标E/A在累积量达到375mg/m2出现显著差别;而组织多普勒收缩功能指标s’在累积量达到300mg/m2就出现显著差别,舒张功能指标e’/a’在累积量达到225mg/m2即出现统计学意义的差别。与健康对照组相比,47例接受表阿霉素化疗的乳腺癌患者第一次治疗前各指标无明显差别(P>0.05)。结论:组织多普勒超声心动图较常规超声心动图能更敏感地监测乳腺癌患者表阿霉素化疗的心脏改变。Objective：To evaluate the clinical value of Tissue Doppler Echocardiography（TDE） for cardiac toxicity by eprubicin in patients with breast cancer.Methods：Among 47 cases received epirubicin in female breast cancer patients,the total volume of epirubicin was 450 mg/m2,the echocardiography was performed after each course of treatment,and relevant parameters were measured;And 20 healthy women were as a control group.Conventional echocardiographic parameters included LVIDd,LVEF,and the ratio of E peak to A peak in velocity of mitral valve（E/A）;And s＇ peak and e＇/ a＇ ratio were measured by TDE.Results：Compared with pre-treatment,conventional echocardiographic parameters appeared significant difference in 450 mg/m2,E/A ratio was significant difference in 375 mg/m2;The difference of s＇ peak in TDE appeared in 300 mg/2,and e＇/a＇ ratio in 225 mg/m2.Compared with the control group,these parameters of pre-treatment in patients were no significant difference.Conclusion：Compared with conventional echocardiography,TDE is a more sensitive technology for cardiac toxicity,by epirubicin in patients with breast cancer.

关 键 词：表阿霉素 心脏毒性 超声心动描记术 多普勒 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541[医药卫生—诊断学]