三维斑点追踪成像技术评价化疗对肺癌患者心肌收缩功能的影响  

Evaluation of myocardial systolic function in lung cancer patients receiving chemotherapy by three dimensional spot tracking imaging technology

作　　者：李朝密 郑慧[1] 姚文[1] 周旺[1] 陈娜[1] 万颖[1] 

机构地区：[1]安徽医科大学第一附属医院超声科,合肥230022

出　　处：《安徽医科大学学报》2016年第2期243-246,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省科技攻关计划项目(编号:1401045016)

摘　　要：目的探讨应用实时三维斑点追踪成像(RT-3DSTI)技术评价化疗药物对肺癌患者左心室心肌收缩功能的影响。方法选取41例肺癌患者,每例分为化疗前、化疗中和化疗后3个阶段。应用二维超声测量左心室内径、室壁厚度,应用RT-3DSTI技术获得左心室整体面积应变(GAS)、整体纵向应变(GLS)、整体圆周应变(GCS)、整体径向应变(GRS)及左室射血分数(LVEF)、心率(HR)等基本参数,并对上述参数进行比较分析。结果 3组间GAS、GLS、GCS、LVEF随化疗周期的进行均减低,且3组间GAS、GLS比较显示化疗前与化疗中、化疗中与化疗后及化疗前与化疗后之间减低差异均有统计学意义(P<0.05),3组间GCS比较显示化疗中与化疗后及化疗前与化疗后之间减低差异均有统计学意义(P<0.05)。化疗后与化疗前之间三维应变参数GAS的差值(r=0.58,P<0.01)、GLS的差值(r=0.36,P<0.05)均与LVEF的差值呈正相关。结论 RT-3DSTI技术所获得的应变参数对发现化疗药物对肺癌患者早期心肌损害,评价左心室心肌收缩功能,指导临床治疗有较高的应用价值。Objective To investigate the value of real-time three-dimensional speckle tracking imaging （RT- 3DSTI） technology in evaluating the influence of chemotherapeutic agents on left ventricular myocardial systolic function in patients with lung cancer. Methods A total of 41 patients with lung cancer were included in this study. Every patient was studied in three stages （before chemotherapy, during chemotherapy and after chemotherapy）. In each stage, the inner diameter of each subject＇ s left ventricle and the thickness of left ventricular wall were measured with two-dimensional ultrasound. Their left ventricular global area strain （GAS）, global longitudinal strain （GLS）, global circular strain（GCS） , global radial strain（GRS） , left volumes ejection fraction （LVEF） , and heart rate （HR）were obtained by RT-3DSTI. The above parameters were compared and analysed. Results The values of GAS,GLS,GCS, LVEF of the three stages all decreased with the proceeding of chemotherapy, Besides,it all showed statistical differences between before chemotherapy group and during chemotherapy group, during chemotherapy group and after chemotherapy group, before chemotherapy group and after chemotherapy group in the values of GAS, GLS（P 〈 0. 05）. It also showed statistical differences between chemotherapy group and during chemotherapy group, before chemotherapy group and after chemotherapy group in the values of GCS （ P 〈 0. 05 ）. The differences of the values of GAS（r =0.58 ,P 〈0. 01 ）, GLS（r =0. 36 ,P 〈0. 05）were both positively related to the differences of the values of LVEF between before chemotherapy group and after chemotherapy group. Conclusion RT-3 DSTI has great significance in diagnosing the early myocardial damage of chemical drugs in patients with lung cancer, evaluating the systolic function of left ventricular, and guiding clinical treatment.

关 键 词：三维斑点追踪成像技术 应变 肺癌 左心室心肌收缩功能 左室射血分数 

分 类 号：R734.2[医药卫生—肿瘤] R445.1[医药卫生—临床医学]