超声心动图监测乳腺癌患者曲妥珠单抗靶向治疗后心脏毒性的临床价值  

Clinical Value of Echocardiography in Monitoring Cardiac Toxicity after Trastuzumab Targeted Therapy in Breast Cancer Patients

作　　者：茹佩儒 黄美英[1] 陆珊珊[1] Ru Peiru;Huang Meiying;Lu Shanshan(Department of Physical Examination,Jiangmen Maternal and Child Health Hospital,Jiangmen,Guangdong 529000)

机构地区：[1]江门市妇幼保健院体检科,广东江门529000

出　　处：《现代医用影像学》2020年第10期1798-1801,1813,共5页Modern Medical Imageology

基　　金：江门市医疗卫生领域科技计划项目(编号:2019020401120004717)。

摘　　要：目的:探讨超声心动图(UCG)监测乳腺癌患者曲妥珠单抗靶向治疗后心脏毒性的临床价值。方法:选取2018年6月-2019年6月我院收治的乳腺癌患者35例,所有患者进行靶向治疗前行超声心动图检查,靶向治疗后第4周、8周、12周及16周分别行超声心动图(UCG)检查。对治疗前后的超声心动图结果进行分析,包括左心射血分数(LVEF)、二尖瓣舒张早期前向血流频谱(E)、二尖瓣舒张晚期前向血流频谱(A)、二尖瓣口舒张早期与舒张晚期最大血流速度的比值(E/A)、收缩期峰值速度(Sm)、舒张早期峰值速度(Em)、舒张晚期峰值速度(Am)、组织多普勒舒张早期峰值速度与舒张晚期峰值速度比值(Em/Am)、二尖瓣舒张早期前向血流频谱与组织多普勒舒张早期峰值速度比值(E/Em)、左房容积指数(LAVI)等超声心动图参数变化。结果:治疗前LVEF、E、E/A与治疗后相比,无明显差异(P>0.05),治疗后A、Am、E/Em、LAVI高于治疗前(P<0.05),治疗后Sm、Em、Em/Am低于治疗前(P<0.05)。结论:曲妥珠单抗靶向治疗乳腺癌患者中,超声心动图监测治疗后心脏毒性的结果更加准确,有一定的临床使用价值。Objective::To investigate the clinical value of echocardiography(UCG) in monitoring cardiac toxicity of trastuzumab after targeted therapy in breast cancer patients.Methods:Thirty-five breast cancer patients treated in our hospital from June 2018 to June 2019 were selected. All patients underwent echocardiography before targeted therapy, and 4 weeks, 8 weeks, 12 weeks, and 16 weeks after targeted therapy. Echocardiography(UCG) was performed separately. Analysis of echocardiographic results before and after treatment, including left ventricular ejection fraction(LVEF), early forward mitral flow spectrum(E), mitral valve late forward flow spectrum(A), two Ratio of maximum venous venous to late diastolic and late diastolic maximum blood flow velocity(E/A), peak systolic velocity(Sm), peak early diastolic velocity(Em), peak late diastolic velocity(Am), early tissue Doppler diastole Echocardiography such as peak velocity to late diastolic peak velocity ratio(Em/Am), early forward mitral diastolic blood flow spectrum and tissue Doppler peak diastolic peak velocity ratio(E/Em), left atrial volume index(LAVI), etc. Graph parameters change.Results::There was no significant difference between LVEF, E, E/A before treatment and after treatment(P>0.05). A, Am, E/Em, and LAVI after treatment were higher than before treatment(P<0.05). Sm, Em and Em/Am were lower than before treatment(P<0.05).Conclusion:In patients with breast cancer targeted by trastuzumab, the results of cardiac toxicity after echocardiography monitoring are more accurate and have certain clinical value.

关 键 词：超声心动图 乳腺癌 曲妥珠单抗 靶向治疗 心脏毒性 

分 类 号：R737.9[医药卫生—肿瘤] R540.45[医药卫生—临床医学]