二维斑点追踪成像技术评价急性白血病患儿柔红霉素化疗后左室扭转功能  

Assessment of Left Ventricular Torsion in Children with Acute Leukemia Induced Therapy by Daunorubicin Using Two-dimensional Speckle Tracking Imaging

作　　者：刘力[1] 夏焙[1] 李姝娜[1] 王缨[2] 李长钢[2] 

机构地区：[1]深圳市儿童医院超声科,广东省深圳市518026 [2]深圳市儿童医院血液科,广东省深圳市518026

出　　处：《中国超声医学杂志》2010年第5期424-427,共4页Chinese Journal of Ultrasound in Medicine

基　　金：深圳市科技计划项目(No.200703012)

摘　　要：目的评价柔红霉素化疗对急性白血病患儿左心室短轴心肌扭转功能的影响。方法应用超声二维斑点追踪成像技术(two-dimensional speckle tracking imaging,2DSI)对60例急性白血病患儿,于柔红霉素化疗前和化疗后对左室短轴基底段和心尖段的心肌节段收缩期峰值旋转运动作定量检测,计算左室心肌收缩期峰值扭转角度。60例健康儿童为正常对照组。结果白血病组化疗后心脏功能指标EF、E/A比值与化疗前比较差异均无统计学意义(P>0.05)。正常儿童左室短轴表现为基底段心肌呈顺时针旋转、心尖段心肌呈逆时针旋转的扭转。白血病组化疗前,左室短轴扭转方向和角度与正常对照组差异均无统计学意义。化疗后左室基底段旋转减小、左室扭转减小,与对照组(11.4°±3.8°对12.3°±3.7°)和化疗前(11.4°±3.8°对12.4°±3.5°)比较差异均有统计学意义(P<0.05)。结论白血病患儿柔红霉素化疗存在心脏扭转功能损伤,二维斑点追踪成像技术可无创性定量评估患儿心脏功能的变化,对临床评价柔红霉素的心脏毒性,预防后遗症的发生有重要意义。Objective To assess left ventricular torsion in children with acute leukemia after induced therapy by daurmrubicin （DNR） . Methods 60 children with acute leukemia before and after induced therapy by DNR and 60 healthy volunteers were enrolled. The left ventricular short-axis images at the levels of mitral annulus and apex were acquired. Using 2-dimensional strain software, the peak systolic rotations were measured in the left ventricular short- axis images and the peak systolic torsions were calculated. Results There was no significant difference between before and after induced therapy by DNR in EF and E/A. In healthy volunteers, left ventricuiar performed a systolic torsion, with a counterclockwise rotation at the apex and a clockwise rotation at the mitral annulus. In the children with acute leukemia induced therapy by DNR, the peak systolic rotations of the level of mitral annulus and the peak systolic torsion decreased, Conclusions The early changes of left ventricular regional myocardial systolic function in children with acute leukemia after induced therapy by DNR can be measured by two-dimensional speckle tracking imaging.

关 键 词：超声心动描记术 二维斑点追踪技术 白血病 柔红霉素 左室扭转 

分 类 号：R733.7[医药卫生—肿瘤] R540.45[医药卫生—临床医学]