左室压力-应变环评价乳腺癌患者化疗后左室局部心肌做功改变的研究  

Evaluation of Left Ventricular Regional Myocardial Work after Chemotherapy in Patients with Breast Cancer by Left Ventricular Pressure-strain Loop

作　　者：唐莎 李华[1] 宋磊 周玉成 Tang Sha;Li Hua;Song Lei;Zhou Yucheng(Department of Cardiac Ultrasound,The Hospital of Traditional Chinese Medicine Affiliatedto Xinjiang Medical University,Urumqi B30000,China)

机构地区：[1]新疆医科大学附属中医医院心脏超声诊断科,乌鲁木齐市830000

出　　处：《中国超声医学杂志》2022年第9期1004-1007,共4页Chinese Journal of Ultrasound in Medicine

基　　金：新疆维吾尔自治区自然科学基金项目(No.2019D01C163)。

摘　　要：目的 探讨采用无创性左室压力-应变环技术评价乳腺癌患者化疗后左室局部心肌做功的变化情况。方法 选取新发乳腺癌术后拟行含蒽环类药物为主的化疗患者52例,于治疗方案实施前(T0)、化疗第2(T2)和第4个周期(T4)及化疗结束后第3(P3m)、第6(P6m)个月行超声心动图检查,分别采集所需切面标准动态图像3个心动周期,脱机分析后获取左室整体和局部心肌做功参数。结果 T4、P3m、P6m期E/A、GWI、GCW、GWE、GLS较T0、T2期减低,E/e′、LAVI、GWW较T0、T2期增高;T4、P3m、P6m期各参数差异有统计学意义;T4、P3m、P6m期左室心肌3个水平的平均局部心肌做功指数(RMWI)和局部心肌做功效率(RMWE)均较T0、T2组逐渐减低,其中平均RMWE以基底段减低为著,平均RMWI以基底段和中段减低为著,均P<0.05。结论 平均RMWI和RMWE可作为客观反映左室心肌局部心脏做功改变的有效参数。Objective To evaluate the changes of left ventricular regional myocardial work in patients with breast cancer after chemotherapy by non-invasive left ventricular pressure-strain loop technique. Methods Fifty-two patients with new breast cancer undergoing postoperative adjuvant chemotherapy containing anthracycline were selected. Echocardiography was performed before the implementation of the treatment regimen(T0), the second(T2) and fourth cycle(T4) of chemotherapy, and 3(P3 m) and 6(P6 m) months after the end of chemotherapy. The standard dynamic images of the required sections were collected for 3 cardiac cycles, respectively. After off-line analysis, the global and regional myocardial work parameters were obtained. Results In T4, P3 m and P6 m stages, E/A, GWI, GCW, GWE and GLS were lower than those in T0 and T2, while E/e′, LAVI, GWW were higher than those in T0 and T2. There were significant differences in the parameters of T4, P3 m and P6 m. The average RMWI and RMWE of left ventricular myocardium in T4, P3 m and P6 m groups were gradually lower than those in T0 and T2 groups, in which the average RMWE decreased more significantly in the basal segment, and the average RMWI decreased more significantly in the basal and middle segments(P<0.05). Conclusions Average RMWI and RMWE are effective parameters to reflect the regional changes of myocardial work of left ventricular myocardium.

关 键 词：乳腺癌 蒽环类药物 左室压力-应变环 心肌做功 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]