纵向分层应变评价乳腺癌新辅助化疗患者左心室收缩功能  

Longitudinal layered strain in observation on left ventricular systolic function of breast cancer patients during neoadjuvant chemotherapy

作　　者：谭雪莹 张晶[1] 任卫东[1] 于佳慧 TAN Xueying;ZHANG Jing;REN Weidong;YU Jiahui(Department of Ultrasound,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院超声科,辽宁沈阳110004

出　　处：《中国医学影像技术》2021年第6期880-884,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金青年项目(81801710)。

摘　　要：目的评价二维斑点追踪成像(2D-STI)技术纵向分层应变判断乳腺癌患者接受新辅助化疗(NACT)前后左心室收缩功能变化的价值。方法纳入47例接受NACT的乳腺癌患者,对比其化疗前(T0)及每次化疗后(T1~T6)心肌肌钙蛋白Ⅰ(cTnⅠ)、心电图(ECG)、超声心动图及2D-STI参数的差异。结果左心室射血分数(LVEF)于T4开始出现降低(P均<0.05),其余cTnⅠ、ECG及常规超声心动图参数T0~T6各时间点差异均无统计学意义(P均>0.05);2D-STI各参数,包括左心室整体纵向应变(LVGLS)、心内膜下心肌(GLS-Endo)、中层(GLS-Mid)及外膜下(GLS-Epi)纵向应变参数均呈下降趋势,其中LVGLS及GLS-Endo于T1开始显著降低,GLS-Mid和GLS-Epi于T3始显著降低(P均<0.05)。结论乳腺癌患者接受NACT期间左心室收缩功能均有不同程度受损;2D-STI技术可较准确地评价其左心室早期收缩功能改变,以GLS-Endo最为敏感。Objective To observe the value of two-dimensional speckle tracking imaging(2 D-STI)longitudinal layered strain on assessment of left ventricular systolic function in breast cancer patients before and after neoadjuvant chemotherapy(NACT).Methods A total of 47 breast cancer patients who underwent NACT were enrolled.Parameters of cardiac troponinⅠ(cTnⅠ),electrocardiogram(ECG),echocardiography,as well as 2 D-STI including left ventricular global longitudinal strain(LVGLS),global longitudinal strain in subendocardial myocardium(GLS-Endo),middle myocardium(GLS-Mid)and subepicardial myocardium(GLS-Epi)were compared before chemotherapy(T0)and after each time of chemotherapy(T1-T6).Results Besides of the left ventricular ejection fraction(LVEF)which significantly decreased at T4(all P<0.05),there was no significant change of cTnⅠ,ECG nor the other echocardiographic parameters(all P>0.05).The longitudinal strain parameters showed decreasing trends,among which LVGLS and GLS-Endo decreased at T1,GLS-Mid and GLS-Epi decreased at T3(all P<0.05).Conclusion Left ventricular systolic function in breast cancer patients was impaired during NACT.2 D-STI technique could accurately evaluate the changes of left ventricular early systolic function,and GLS-Endo was the most sensitive.

关 键 词：乳腺肿瘤 新辅助治疗 心房功能 左 超声心动描记术 二维斑点追踪成像 

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