超声心动图对乳腺癌患者曲妥珠单抗靶向药物治疗后早期心脏毒性的监测  

Echocardiographic Monitoring of Early Cardiotoxicity in Breast Cancer Patients after Trastuzumab Targeted Drug Therapy

作　　者：黄美英[1] 茹佩儒 岑红艺[1] HUANG Mei-ying;RU Pei-ru;CEN Hong-yi(Physical Examination Center,Maternal and Child Health Hospital of Jiangmen City,Jiangmen,Guangdong Province,529000 China)

机构地区：[1]江门市妇幼保健院体检中心,广东江门529000

出　　处：《中外医疗》2021年第2期20-22,共3页China & Foreign Medical Treatment

基　　金：江门市科研计划基金项目(2019D018)。

摘　　要：目的探讨超声心动图对乳腺癌患者曲妥珠单抗靶向药物治疗后早期心脏损伤的监测价值。方法方便选取该院2018年3月—2019年2月期间首次确诊的30例乳腺癌患者为研究对象,所有患者均实施曲妥珠单抗靶向药物治疗,对比分析患者治疗前与治疗后的4、8、12、16个周期的超声心动图检查结果。结果乳腺癌患者曲妥珠单抗靶向药物治疗后4、8、12、16个周期同治疗前相比,其收缩期峰值速度(Sm)、舒张早期峰值速度(Em)、舒张早期峰值速度/舒张晚期峰值速度(Em/Am)均下降,而(Am)与二尖瓣舒张早期前向血流频谱(E/Em)均升高,左心房容积指数(LAVI)在治疗后呈现出升高趋势。其中治疗前与治疗后4、8、12、16个周期对应的LAVI分别为(22.34±3.38)mL/m^(2)、(24.38±3.61)mL/m^(2)、(26.81±2.46)mL/m^(2)、(29.16±2.90)mL/m^(2)、(32.58±4.95)mL/m^(2),治疗前与治疗16个周期比较,差异有统计学意义(t=9.357,P<0.001)。E/Em同LAVI存在正相关(r=0.800,P<0.05)。结论乳腺癌患者曲妥珠单抗靶向药物治疗后可出现心脏损伤问题,以舒张功能减退为主,通过超声心动图检查配合相关参数变化可作为早期左心功能损伤的重要评价依据。Objective To explore the value of echocardiography in monitoring the early heart injury in breast cancer patients after trastuzumab targeted drug therapy.Methods Selected conveniently 30 breast cancer patients diagnosed for the first time in the hospital from March 2018 to February 2019 as the research subjects.All patients were treated with trastuzumab targeted drug therapy,and their results before and after treatment of 4,8,12,16 cycles of echocardiographic examination results were compared and analyzed.Results Breast cancer patients by bead sheet resistance to targeted drug therapy after 4,8,12,16 cycle compared with before treatment,the systolic peak velocity(Sm),early diastolic peak velocity(Em),early diastolic peak velocity/late diastolic peak velocity(Em/Am)decreased,and(Am)and mitral valve early diastolic forward blood flow spectrum(E/Em)are elevated,left atrial volume index(LAVI)after treatment present a rising trend.LAVI corresponding to cycles 4,8,12 and 16 before and after treatment were(22.34±3.38)mL/m^(2),(24.38±3.61)mL/m^(2),(26.81±2.46)mL/m^(2),(29.16±2.90)mL/m^(2) and(32.58±4.95)mL/m^(2),respectively.Comparison between cycles before and after treatment showed statistically significant difference(t=9.357,P<0.001).There was a positive correlation between E/Em and LAVI(r=0.800,P<0.05).Conclusion Trastuzumab-targeted drug therapy in breast cancer patients can cause heart damage,mainly diastolic dysfunction.The echocardiographic examination with changes in related parameters can be used as an important evaluation basis for early left ventricular function damage.

关 键 词：超声心动图 乳腺癌 曲妥珠单抗 靶向药物 早期心脏损伤 心脏功能 评价指标 

分 类 号：R737.9[医药卫生—肿瘤]