实时超声心动图监测蒽环类化疗药物对淋巴瘤患者心血管损伤的价值  

Monitoring the cardiovascular injury of anthracycline chemotherapy drugs in lymphoma patients by real-time echocardiography

作　　者：薛静[1] 陈胜江[1] 张周龙[1] 段利科[1] 王慧芬 XUE Jing;CHEN Shengjiang;ZHANG Zhoulong;DUAN Like;WANG Huifen(Department of Ultrasound,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,河南洛阳471000

出　　处：《医学影像学杂志》2022年第11期1888-1891,共4页Journal of Medical Imaging

基　　金：河南省科技攻关联合共建项目(编号:LHGJ20190563)。

摘　　要：目的探讨实时超声心动图监测蒽环类化疗药物对淋巴瘤患者心血管损伤的价值。方法选取本院行蒽环类化疗药物治疗的80例淋巴瘤患者,分别于化疗前、化疗2个周期、化疗4个周期、化疗6个周期行实时超声心动图监测。结果化疗前及化疗2、4、6个周期的左心室后壁舒张末厚度(LVPWd)、收缩末容积(ESV)、左心室舒张末内径(LVIDd)、左心室舒张末容积(EDV)、室间隔舒张末期厚度(IVS)、左心室射血分数(LVEF)之间均差异无统计学意义(P>0.05),化疗前及化疗2、4、6个周期的左心室整体面积应变(GAS)、整体纵向应变(GLS)数值随化疗周期增加而显著减低(P<0.05),而整体圆周应变(GCS)、整体径向应变(GRS)前后差异无统计学意义(P>0.05)。结论在实时超声心动图监测应变参数中,GAS、GLS均随着化疗周期增加显著降低,提示GAS对于淋巴瘤患者蒽环类药物化疗早期左心室功能损害具有高度敏感性,可为左心室功能减低评估提供客观依据。实时超声心动图监测能较早发现蒽环类药物引起左心室收缩功能的改变,对临床适时调整化疗方案有重要意义。Objective To explore the monitoring of cardiovascular injury of anthracycline chemotherapy drugs in lymphoma patients by real-time echocardiography.Methods The subjects were 80 lymphoma patients who were scheduled to receive anthracycline chemotherapy in our hospital from November 2019 to February 2022.They were monitored by real-time echocardiography before chemotherapy,2 cycles of chemotherapy,4 cycles of chemotherapy and 6 cycles of chemotherapy.Results There was no significant difference in left ventricular posterior wall end diastolic thickness(LVPWd),end systolic volume(ESV),left ventricular end diastolic diameter(LVIDd),left ventricular end diastolic volume(EDV),ventricular septal end diastolic thickness(IVS)and left ventricular ejection fraction(LVEF)before chemotherapy and 2,4 and 6 cycles of chemotherapy(P>0.05);Before chemotherapy and 2,4 and 6 cycles of chemotherapy,the values of left ventricular global area strain(GAS)and global longitudinal strain(GLS)decreased significantly with the increase of chemotherapy cycle(P<0.05),while there was no significant difference in global circumferential strain(GCS)and global radial strain(GRS)(P>0.05).Conclusion In the strain parameters monitored by real-time echocardiography,GAS and GLS decrease significantly with the increase of chemotherapy cycle,suggesting that GAS is highly sensitive to the early left ventricular function damage of anthracycline chemotherapy in lymphoma patients,which can provide an objective basis for the evaluation of left ventricular function decline.Real time echocardiography can detect the changes of left ventricular systolic function caused by anthracycline drugs earlier,which is of great significance for timely adjustment of chemotherapy regimen in clinic.

关 键 词：蒽环类化疗药物 实时超声心动图监测 淋巴瘤 心血管损伤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541[医药卫生—诊断学]