三维斑点追踪成像评价乳腺癌患者蒽环类药物化疗后的心脏功能  

Three-dimensional Speckle Tracking Echocardiography for Evaluating Cardiac Function in Breast Cancer Patients Treated with Anthracycline

作　　者：张帅[1] 徐晓红[1] 张慷[1] 刘丽娟[1] 谢君[1] 

机构地区：[1]广东医学院附属医院超声科,广东湛江524001

出　　处：《中国医学影像学杂志》2014年第10期745-748,753,共5页Chinese Journal of Medical Imaging

摘　　要：目的探讨三维斑点追踪成像技术评价乳腺癌患者蒽环类药物化疗后心脏功能的价值。资料与方法追踪观察32例乳腺癌患者术后化疗前(A组)、化疗2个周期后(B组)、化疗4个周期后(C组)的心脏三维超声心动图表现,比较3组左心室整体纵向应变(GLS)、整体径向应变(GRS)、整体圆周应变(GCS)、整体面积应变(GAS)、舒张早期整体面积应变率(EASR)、舒张早期三维速度(3DVe)的差异,并分析各参数间的相关性。结果三维斑点追踪成像参数中,C组GCS、GAS、EASR明显低于A组,差异有统计学意义(t=3.555、3.692、3.590,P<0.01),B组EASR低于A组,差异有统计学意义(t=2.190,P<0.05);3组GLS、GRS、3DVe比较,差异无统计学意义(F=2.305、1.957、1.205,P>0.05)。相关分析结果显示,EASR与等容舒张时间(IVRT)呈负相关(r=-0.44,P<0.01),与组织多普勒舒张早期峰值及舒张早期、晚期峰值比呈正相关(r=0.49、0.32,P<0.01);GRS与组织多普勒收缩期峰值呈正相关(r=0.21,P<0.05)。结论三维斑点追踪成像技术能敏感地反映乳腺癌患者蒽环类药物化疗后心脏早期舒张功能的变化。Purpose To investigate the value of three-dimensional speckle tracking echocardiography in evaluating the cardiac function in breast cancer patients treated with Anthracycline. Materials and Methods Thirty-two breast cancer patients were followed with three-dimensional echocardiography prechemotherapy（group A）, 2 cycles（group B） and 4 cycles（group B） postchemotherapy to compare left ventricle global longitudinal strain（GLS）, global radial strain（GRS）, global circular strain（GCS）, global area strain（GAS）, early diastolic global area strain rate（EASR）, and early diastolic 3D velocity（3DVe）. Results GCS, GAS and EASR were significantly lower in group C than group A（t=3.555, 3.692 and 3.590, P〈0.01）; EASR was lower in group B than group A with statistical significance（t=2.190, P〈0.05）. GLS, GRS and 3DVe were not significantly different among three groups（F=2.305, 1.957 and 1.205, P〈0.05）. EASR was negatively correlated with IVRT（r =- 0.44, P〈0.01）; EASR was positively correlated with Em（r =0.49, P〈0.01） and Em/Am（r =0.32, P〈0.01）. GSR was positively correlated with Sm（r =0.21, P〈0.05）. Conclusion Three-dimensional echocardiography sensitively detects the early changes in diastole function in breast cancer patients treated with Anthracycline.

关 键 词：乳腺肿瘤 外科手术 药物疗法 蒽环类 超声心动描记术 三维 斑点追踪成像 心室功能 左 

分 类 号：R737.9[医药卫生—肿瘤] R730.41[医药卫生—临床医学]