高频超声评价表阿霉素复合药物对乳腺癌患者血管内皮功能的影响  

Evaluation of epirubicin effects on vascular endothelial function in patients with breast cancer using high frequency ultrasound

作　　者：崔洪岩[1] 张宇虹[1] 礼广森[1] 黄冬梅[1] 

机构地区：[1]大连医科大学附属第二医院超声科,辽宁大连116027

出　　处：《中国医学影像技术》2015年第3期393-396,共4页Chinese Journal of Medical Imaging Technology

基　　金：辽宁省教育厅科学研究计划资助(05L109)

摘　　要：目的采用高频超声评估表阿霉素（Epi）复合药物对乳腺癌患者血管内皮功能的影响。方法收集140例乳腺癌术后患者,分为3组：A组为对照组,40例,未给予化疗。B组50例,采用以Epi为主化疗方案（环磷酰胺＋Epi＋5-氟尿嘧啶）,Epi累积剂量180-240mg/m^2;C组50例,化疗方案与B组相同,Epi≥360mg/m^2。对3组患者静息状态、反应性充血（内皮依赖性）及含服硝酸甘油后内皮功能（内皮非依赖性）进行检测,比较内皮依赖性及内皮非依赖性肱动脉内径变化。结果 ①A组与B组肱动脉内皮依赖性舒张功能（EDD）的差异无统计学意义[（8.05±1.89）%vs（7.48±2.06）%,P〉0.05],C组EDD[（6.49±1.63）%]明显减低,与A组、B组的差异均有统计学意义（P均〈0.05）;②与A组[（14.81±4.20）%]比较,B组[（14.31±3.89）%]、C组内皮非依赖性舒张功能[NEDD,（13.31±3.45）%]均减低,但3组间差异无统计学意义（P〉0.05）;③EDD、NEDD与静息状态下肱动脉基础内径（D0）无相关性（r=-0.02,0.01,P均〉0.05）,EDD、NEDD与反应性充血后肱动脉内径（D1）呈正相关（r=0.43,0.17,P〈0.05）,与含服硝酸甘油后肱动脉内径（D2）呈正相关（r=0.23,0.69,P〈0.05）。结论较大剂量Epi复合药物可致乳腺癌患者EDD功能受损,但其NEDD功能未见明显受损。Objective To evaluate the epirubicin（Epi）effects on vascular endothelial function in patients with breast cancer using high frequency ultrasound.Methods One hundred and forty breast cancer patients after surgery were divided into three groups that based on Epi chemotherapy（cyclophosphamide＋Epi＋5-fluorouracil）,i.e.Forty patients without chemotherapy as the control group（group A）,Fifty patients in group B were given Epi of 180-240mg/m^2.Fifty patients in group C were given Epi of≥360mg/m^2.The inner diameter of the brachial artery on resting state（D0）,reactive hyperemia（D1）and after administering nitroglycerin（D2）,were measured by high frequency ultrasound.And then the endothelial dependent dilation（EDD）,non-endothelial dependent dilation（NEDD）were calculated and compared among three groups.Results ①The difference of EDD between group A（[8.05±1.89]%）and group B（[7.48±2.06]%）was not significant（P〉0.05）,but EDD of group C（[6.49±1.63]%）was obviously lower and had significant difference compared to group A and group B（both P〈0.05）.②Compared with group A（[14.81±4.20]%）,NEDD of group B（[14.31±3.89]%）and group C（[13.31±3.45]%）were lower,but had no significant difference among three groups（P〉0.05）.③There were no correlation between EDD,NEDD and D0（r=-0.02,0.01,P 均〉 0.05）.EDD and NEDD were positive correlation with D1（r=0.43,0.17,P〈0.05）and D2（r=0.23,0.69,P〈0.05）.Conclusion Large dose of Epi can cause EDD impaired in breast cancer patients after surgery,but the NEDD is not affected.

关 键 词：高频超声 内皮依赖性舒张 内皮非依赖性舒张 表阿霉素 乳腺肿瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]