复合超声心动图在检测淋巴瘤化疗所致心脏毒性中的应用价值  

Application value of composite echocardiography technique in detecting cardiotoxicity caused by lymphoma chemotherapy

作　　者：薛静[1] 张周龙[1] 陈胜江[1] 袁小志[2] 段利科[1] 王慧芬 Xue Jing;Zhang Zhoulong;Chen Shengjiang;Yuan Xiaozhi;Duan Like;Wang Huifen(Department of Ultrasound,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China;Department of Oncology,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院超声科,洛阳471000 [2]河南科技大学第一附属医院肿瘤科,洛阳471000

出　　处：《国际医药卫生导报》2022年第16期2236-2240,共5页International Medicine and Health Guidance News

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20190563)。

摘　　要：目的探讨超声复合技术在动态监测淋巴瘤化疗所致心脏毒性中的应用价值。方法选择2020年1月至2021年12月河南科技大学第一附属医院就诊的非霍奇金淋巴瘤化疗患者28例(化疗组),其中男12例、女16例,年龄(51.22±10.17)岁;同期选择健康志愿者30例为对照组,其中男12例、女18岁,年龄(50.19±12.06)岁。所有患者在化疗后2周期、4周期、6周期采用实时二维超声心动图(RT-2DE)、组织多普勒成像(TDI)、二维斑点追踪成像(2D-STI)检测各心功能指标。观察两组左心室射血分数(LVEF)、左心室前后径(LV)、左心房前后径(LA)、E峰、A峰、E/A值、二尖瓣E峰减速时间(DT)、血流频谱舒张早期速度(E)与二尖瓣环舒张早期运动峰速度(e’)比值、左心室整体圆周应变(LVGCS)、左心室整体径向应变(LVGRS)、左心室整体纵向应变(LVGLS)、左心室扭转角度峰值(LVPtw)。计量资料采用独立样本t检验或单因素方差分析,计数资料采用卡方检验。结果化疗组化疗后2周期、4周期LVEF、LV、LA、E峰、A峰、E/A与对照组比较,差异均无统计学意义(均P>0.05);化疗2周期化疗组DT与对照组比较,差异无统计学意义(P>0.05),化疗4周期化疗组DT为(213.16±21.23)ms,与对照组(181.26±20.23)ms比较,差异有统计学意义(P<0.05)。化疗组化疗后6周期LVEF为(49.01±4.12)%、LV为(56.68±4.32)mm、LA为(43.64±4.02)mm、E峰为(78.36±12.20)cm/s、A峰为(90.96±12.61)cm/s、E/A为(0.76±0.21)、DT为(256.23±32.14)ms,与对照组比较差异均有统计学意义(均P<0.05)。化疗组化疗后2周期e’、E/e’与对照组比较,差异均无统计学意义(均P>0.05);化疗组化疗后4周期e’为(8.22±1.27)cm/s、E/e’为(18.17±3.12),化疗6周期e’为(4.29±2.17)cm/s、E/e’为(20.17±4.06),与对照组比较差异均有统计学意义(均P<0.05)。化疗组化疗后2周期、4周期、6周期LVGRS、LVGCS、LVGLS、LVPtw与对照组比较,差异均有统计学意义(均P<0.05)。�Objective To investigate the application value of composite echocardiography technique in dynamically monitoring cardiotoxicity caused by lymphoma chemotherapy.Methods A total of 28 non-Hodgkin lymphoma patients underwent chemotherapy in The First Affiliated Hospital of Henan University of Science and Technology,including 12 males and 16 females,aged(51.22±10.17)years;30 healthy volunteers were selected as controls during the same period,including 12 males and 18 females,aged(50.19±12.06)years.Real-time two-dimensional echocardiography(RT-2DE),tissue Doppler imaging(TDI),and two-dimensional speck-tracking imaging(2D-STI)were used to detect the cardiac function indexes in all patients after 2,4,and 6 cycles of chemotherapy.The left ventricular ejection fraction(LVEF),left ventricular anterior diameter(LV),left atrial anterior diameter(LA),peak E,peak A,E/A,mitral peak E deceleration time(DT),the ratio of early diastolic velocity of blood flow spectrum(E)to early diastolic peak velocity of mitral annulus(e'),left ventricular global circumferential strain(LVGCS),left ventricular global radial strain(LVGRS),left ventricular global longitudinal strain(LVGLS),and peak left ventricular twist angle(LVPtw)were observed and compared in both groups.Independent sample t test or one-way ANOVA was used for the measurement data,and Chi-square test was used for the count data.Results There were no statistically significant differences in the LVEF,LV,LA,peak E,peak A,and E/A between the chemotherapy group and the control group after 2 and 4 cycles of chemotherapy(all P>0.05).There was no statistically significant difference in the DT between the chemotherapy group and the control group after 2 cycles of chemotherapy(P>0.05),but there was a statistically significant difference after 4 cycles of chemotherapy[(213.16±21.23)ms vs.(181.26±20.23)ms](P<0.05).After 6 cycles of chemotherapy,the LVEF,LV,LA,peak E,peak A,E/A,and DT in the chemotherapy group were(49.01±4.12)%,(56.68±4.32)mm,(43.64±4.02)mm,(78.36±12.20)cm/s,(90.96±12

关 键 词：RT-2DE TDI 2D-STI 肿瘤 化疗 心脏毒性 

分 类 号：R733.1[医药卫生—肿瘤]