左心室压力-应变环对比观察脂质体多柔比星与表柔比星对乳腺癌患者左心室功能的影响  

Left ventricular pressure strain loops for comparison of effect between pegylated liposomal doxorubicin and epirubicin on left ventricular function in breast cancer patients

作　　者：张哲元 吕琼芳[2] 冉洪玲 胡佳[1] 曾曦 袁新春[1] ZHANG Zheyuan;LYU Qiongfang;RAN Hongling;HU Jia;ZENG Xi;YUAN Xinchun(Department of Ultrasound Medicine,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China;Department of Ultrasound,Yifeng County People's Hospital,Yichun 336300,China)

机构地区：[1]南昌大学第一附属医院超声医学科,江西南昌330006 [2]宜丰县人民医院超声室,江西宜春336300

出　　处：《中国医学影像技术》2022年第6期848-852,共5页Chinese Journal of Medical Imaging Technology

基　　金：江西省卫生健康委科技计划(202210457)。

摘　　要：目的采用左心室压力-应变环(LV PSL)对比观察脂质体多柔比星(PLD)及表柔比星(EPI)对乳腺癌患者左心室功能的影响。方法纳入78例首次接受化学治疗(化疗)的女性乳腺癌患者,根据化疗方案将其分为PLD组(n=40)和EPI组(n=38);另招募30名健康志愿者作为对照组。于化疗开始前及化疗4个周期后进行心脏超声心动图检查,获得常规、应变及心肌做功参数,并进行组间比较。结果化疗前,PLD组及EPI组常规、应变及心肌做功参数与对照组差异均无统计学意义(P均>0.05)。化疗4个周期后,PLD组整体做功指数(GWI)、整体做功效率(GWE)及整体有用功(GCW)均低于而整体无用功(GWW)高于对照组(P均<0.05),EPI组整体纵向应变(GLS)、GWI、GWE及GCW均低于而GWW高于对照组(P均<0.05);PLD组GLS、GWI、GWE及GCW均高于EPI组(P均<0.05)。结论PLD心脏毒性小于EPI;以LV PSL所获心肌做功参数可用于评价化疗过程中乳腺癌患者左心室功能改变。Objective To comparatively observe the impact of pegylated liposomal doxorubicin(PLD)and epirubicin(EPI)on left ventricular function in breast cancer patients using left ventricular pressure strain loops(LV PSL).Methods Totally 78 female breast cancer patients who underwent the first time chemotherapy were enrolled and divided into PLD group(n=40)and EPI group(n=38)according to the chemotherapy regimen,while 30 healthy volunteers were selected as control group.Echocardiography was performed before and at the end of the fourth courses of chemotherapy,and parameters of routine ultrasound,strain and myocardial work were obtained and compared among groups.Results Before chemotherapy,there was no significant difference of parameters of routine ultrasound,strain nor myocardial work among 3 groups(all P>0.05).After 4 courses of chemotherapy,global work index(GWI),global work efficiency(GWE)and global constructive work(GCW)in PLD group were lower those in control group,while global waste work(GWW)in PLD group was higher than that in control group(all P<0.05).Meanwhile,global longitudinal strain(GLS),GWI,GWE and GCW in EPI group were lower but GWW was higher than those in control group(all P<0.05),GLS,GWI,GWE and GCW in PLD group were higher than those in EPI group(all P<0.05).Conclusion The cardiotoxicity of PLD was lower than that of EPI during chemotherapy.Parameters of myocardial work obtained using LV PSL could be used to evaluate the changes of left ventricular function in breast cancer patients during chemotherapy.

关 键 词：乳腺肿瘤 心室功能 左 脂质体多柔比星 表柔比星 超声心动描记术 

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