速度向量成像评价乳腺癌患者蒽环类药物治疗后左心房收缩功能  

Velocity vector imaging for evaluation on left atrial systolic function in breast cancer patients undergoing anthracycline therapy

作　　者：郭耀霞 红华 冯天鹰 尹海军 梁丹艳 吴国柱 GUO Yaoxia;HONG Hua;FENG Tianying;YIN Haijun;LIANG Danyan;WU Guozhu(Department of Ultrasonic Medicine,the Inner Mongolia Autonomous Region People's Hospital,Hohhot 010010,China;Department of Ultrasonic Medicine,Shenzhen Baoan District Central Hospital,Shenzhen 518100,China)

机构地区：[1]内蒙古自治区人民医院超声医学科,内蒙古呼和浩特010010 [2]深圳市宝安区中心医院,广东深圳518100

出　　处：《中国医学影像技术》2021年第1期54-58,共5页Chinese Journal of Medical Imaging Technology

基　　金：内蒙古自治区自然科学基金(2017MS0850)。

摘　　要：目的应用速度向量成像(VVI)评价蒽环类药物对乳腺癌患者左心房收缩功能的影响。方法选取30例接受蒽环类药物治疗的乳腺癌患者,采用VVI观察并比较治疗前、治疗第6、8周期及治疗结束6个月后左心房最小容积(LAV min)、左心房P容积(LAV p)、左心房主动射血分数(LAAEF)和舒张晚期左心房峰值应变率(SRa)。结果治疗第6周期LAV min、LAV p、LAAEF与治疗前比较差异均无统计学意义(P均>0.05);第8周期LAV min、LAV p及LAAEF与治疗前差异均有统计学意义(P均<0.05);第6周期及治疗结束6个月后LAV min、LAV p及LAAEF与治疗第8周期差异均无统计学意义(P均>0.05)。治疗第6周期心肌6个节段SRa较治疗前升高(P<0.05),第8周期心肌6个节段SRa较治疗前及治疗第6周期时均减低(P均<0.05)。治疗结束6个月后间隔上段SRa较治疗第8周期升高(P<0.05),其他节段SRa差异均无统计学意义(P均>0.05)。结论蒽环类药物影响左心房收缩功能,初期可在一定程度上代偿,最终出现失代偿,导致左心房收缩功能减低;利用VVI可准确加以评估。Objective To evaluate the impact of anthracyclines on left atrial systolic function in breast cancer patients with velocity vector imaging(VVI).Methods Totally 30 breast cancer patients treated with anthracycline drugs were selected.Left atrial minimum volume(LAV min),left atrial P volume(LAV p),left atrial active ejection fraction(LAAEF)and late diastolic peak left atrial strain rate(SRa)were observed and compared before and after 6 and 8 cycles of chemotherapy,also 6 months after the ending of chemotherapy.Results No significant difference of LAV min,LAV p nor LAAEF was detected at the 6th cycles of chemotherapy and before chemotherapy(all P>0.05),while significant difference of LAV min,LAV p and LAAEF were found at the 8th cycle and before chemotherapy(all P<0.05).No significant difference of LAV min,LAV p and LAAEF at the 8th cycle of chemotherapy compared with those at the 6th cycle of chemotherapy and 6 months after the ending of chemotherapy(all P>0.05).Compared with that before chemotherapy,SRa of 6 segments of myocardium increased at the 6th cycle but decreased at the 8th cycle of chemotherapy(both P<0.05).Compared with that at the 6th cycle of chemotherapy,SRa of 6 segments of myocardium decreased at the 8th cycle of chemotherapy(P<0.05).Six months after the ending of chemotherapy,SRa in upper segment was higher than that at the 8th cycle of chemotherapy(P<0.05),and there was no significant difference of SRa in other segments(all P>0.05).Conclusion Anthracyclines had impact on left atrial systolic function,which could first be compensated to a certain extent,but eventually lead to decompensation and reduction of left atrium systolic function.VVI was able to sensitively and accurately evaluate the changes of left atrial systolic function during the above procedures.

关 键 词：乳腺肿瘤 心房功能 左 蒽环素 超声检查 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]