左室分层应变评价表阿霉素复合药物对乳腺癌患者左室心肌圆周应变的影响  

Left Ventricular Myocardial Layer-specific Strain in Patients Induced by Epirubicin Using Speckle Tracking Imaging

作　　者：崔洪岩[1] 礼广森[1] 张宇虹[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,辽宁省大连市116027

出　　处：《中国超声医学杂志》2016年第4期314-316,共3页Chinese Journal of Ultrasound in Medicine

基　　金：辽宁省教育厅科学研究计划资助(No.05L109)

摘　　要：目的应用斑点追踪成像技术（STI）的分层应变,评价表阿霉素复合药物对左室各层心肌圆周收缩功能的影响。方法 140例乳腺癌患者,分为3组：A组,40例,未给予化疗,为对照组。B组50例,化疗方案（环磷酰胺＋表阿霉素＋5-氟尿嘧啶）,表阿霉素（Epi）累积剂量180~240mg/m2。C组50例,同样化疗方案,Epi≥360mg/m2。获取胸骨旁左室短轴二尖瓣口、乳头肌、心尖水平二维图像,测定3组患者各水平心内膜下、中层和心外膜下心肌的圆周应变峰值（CS）。结果 （1）各组的CS存在梯度特征：心内膜下心肌〉中层心肌〉心外膜下心肌,基底段〉中段〉心尖段。（2）B、C组的心外膜下、中层、心内膜下心肌的CS均减低,其中C组最低,与A组比较及B、C两组间比较均无显著性差异（P〉0.05）。结论 STI可以评价表阿霉素复合药物对左室壁圆周收缩功能的影响,为临床判断表阿霉素对心肌的损害程度提供新的检查方法。Objective To investigate the value of layer-specific strain using speckle tracking imaging（STI）in evaluating the left ventricular circumferential systolic function in patients with Epirubicin.Methods One hundred and forty breast cancer patients were divided ino three groups.Forty patients after surging without chemotherapy in group A as the control group.Fifty patients in group B were given Epirubicin（Epi）of 180~240 mg/m2.Fifty patients in group C were given Epi of≥360mg/m2.High frame rate two-dimensional images were recorded from short-axis view at the mitral annulus,papillary muscle and apical levels of the left ventricle during three consecutive cardiac cycles on basal.Peak systolic circumferential strain（CS）were measured in subendocardium,midmyocardium and subepicardium.Results（1）The CS of subendocardium was the highest,and subepicardium was the lowest in three groups.Circumferential 3-layer strain was highest in the apex and lowest in the base.（2）CS of subendocardium,midmyocardium and subepicardium in group B and C were reduced,group C is the lowest,when compared each other and with group A,had no significant difference（P〉0.05）.Conclusions CS of transmural ventricular wall may be useful for early evaluation of the Epi severity.

关 键 词：斑点追踪成像 表阿霉素 分层应变 圆周 

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]