左心室压力-应变环技术评估结直肠癌患者贝伐珠单抗联合化疗早期心功能损害  

Assessment of early cardiac dysfunction in colorectal cancer patients with bevacizumab combination chemotherapy by left ventricular pressure-strain loop technology

作　　者：邹文娟[1] 宋娜[1] 田甜[2] 贾冰 程俊[1] 艾亮[1] 封雪 ZOU Wenjuan;SONG Na;TIAN Tian;JIA Bing;CHENG Jun;AI Liang;FENG Xue(Department of Oncology,Chongqing Hospital of Traditional Chinese Medicine,Chongqing 400021,China)

机构地区：[1]重庆市中医院肿瘤科,400021 [2]重庆市中医院超声科,400021

出　　处：《临床超声医学杂志》2023年第8期673-676,共4页Journal of Clinical Ultrasound in Medicine

基　　金：重庆市科卫联合项目(2020MSXM093、2020ZY023614);成都中医药大学“杏林学者”学科人才科研提升计划(2021YYZX2021087);重庆市科研机构绩效激励引导专项(2021jxyn2021-2-12)。

摘　　要：目的 探讨左心室压力-应变环技术评估结直肠癌患者贝伐珠单抗联合化疗早期心功能损害的临床价值。方法 选取我院行贝伐珠单抗+FOLFOX抗肿瘤治疗的晚期结直肠癌患者50例,于治疗前、治疗3个周期、治疗6个周期行常规超声心动图测量心腔内径、二尖瓣口舒张早期峰值流速(E)、等容舒张时间(IVRT)、二尖瓣环舒张早期峰值速度(e’),计算E/e’;二维斑点追踪技术及左心室压力-应变环技术获取整体纵向应变(GLS)、达峰时间离散度(PSD)、心肌整体做功指数(GWI)、整体做功效率(GWE)、整体有用功(GCW)及整体无用功(GWW)。比较治疗前、治疗3个周期、治疗6个周期上述各参数的差异。结果 与治疗前比较,治疗3个周期后E/e’、GWW均增加,GWI减低,治疗6个周期E/e’、IVRT、GWW均增加,e’、GLS、GWI、GWE均减低,差异均有统计学意义(均P<0.05);与治疗3个周期比较,治疗6个周期E/e’、IVRT均增加,GWE减低,差异均有统计学意义(均P<0.05)。结论 左心室压力-应变环技术能敏感、早期评估贝伐珠单抗联合化疗的结直肠癌患者左心室收缩功能,为其精准化诊治提供更多的量化指标。Objective To explore the clinical value of left ventricular pressure-strain loop technology in the assessment of early cardiac dysfunction in colorectal cancer patients with bevacizumab combined with chemotherapy.Methods A total of50 patients with advanced colorectal cancer with bevacizumab+FOLFOX therapy were examined before treatment and after 3 and6 cycles of treatment.Conventional ultrasound was performed to measure the inner diameter of the heart cavity,the early mitral opening peak diastolic velocity(E),the isovolemic diastolic time(IVRT),the early mitral ring peak diastolic velocity(e'),and E/e'was calculated.Two-dimensional speckle tracking imaging and left ventricular pressure-strain loop technology were applied to obtain global longitudinal strain(GLS),peaking time dispersion(PSD),global work index(GWI),global work efficiency(GWE),global constructive work(GCW) and global wasted work(GWW).The differences of the above parameters were compared among pre-treatment,after 3 cycles and 6 cycles of treatment.Results Compared with pre-treatment,E/e'and GWW increased and GWI decreased after 3 cycles of treatment,and E/e',IVRT and GWW increased,while e',GLS,GWI and GWE decreased after 6 cycles of treatment,the differences were statistically significant(all P<0.05).In addition,E/e'and IVRT increased and GWE decreased after 6 cycles of treatment compared with 3 cycles of treatment,with statistically significant differences(all P<0.05).Conclusion Left ventricular pressure-strain loop can sensitively and early assessment of left ventricular systolic function in colorectal cancer patients with bevacizumab combined with chemotherapy,which providing more quantitative indicators for precise diagnosis and treatment.

关 键 词：超声心动描记术 左心室压力-应变环 结直肠癌 贝伐珠单抗 

分 类 号：R540.45[医药卫生—心血管疾病] R735.37[医药卫生—内科学]