左室压力应变环联合三维斑点追踪技术评价不同年龄段乳腺癌患者化疗后的左室收缩功能  

Evaluation of left ventricular systolic function after chemotherapy in breast cancer patients of different ages by left ventricular pressure-strain loop combined with 3D STI

作　　者：张铭轩 李晓东[1] 张艳丽[1] 于微[1] 马雁[1] 张永飞 王小丛[1] ZHANG Ming-xuan;LI Xiao-dong;ZHANG Yan-li;YU Wei;MA Yan;ZHANG Yong-fei;WANG Xiao-cong(The First Hospital of Bethune,Jilin University,Changchun 130012,China)

机构地区：[1]吉林大学白求恩第一医院,吉林长春130012

出　　处：《中国临床医学影像杂志》2023年第8期549-554,共6页Journal of China Clinic Medical Imaging

基　　金：吉林省科技发展计划项目(编号20190303169SF)。

摘　　要：目的:应用左室压力应变环联合三维斑点追踪技术评价接受蒽环类药物的乳腺癌化疗患者左室收缩功能的改变,探索两种技术在临床上早期发现化疗所致心脏损伤的价值,并对比不同年龄段心脏损伤的差异。方法:选取2020年12月—2022年1月本院经粗针穿刺活检确诊为乳腺癌的患者54例,根据患者年龄不同分为两组:年龄<40岁(A组),年龄≥40岁(B组),化疗前左心室射血分数(LVEF)>55%,分别于化疗前(T0),2个化疗周期后(T2)、4个化疗周期后(T4)、6个化疗周期后(T6)进行超声心动图检测,同时,分别选取27例年龄相匹配的常规体检女性患者作为对照组。分析普通二维、三维参数、左室心肌做功参数及三维斑点追踪参数并得到相关指标。结果:A组中病例组T4、T6时与T0时相比,左室整体纵向应变(GLS)、整体做功指数(GWI)、整体有效功(GCW)差异有统计学意义(P<0.05);B组中病例组T2时与T0时相比,GCW差异有统计学意义(P<0.05);B组中病例组T4、T6时与T0时相比,GLS、GWI、GCW差异有统计学意义(P<0.05);A组中病例组T6时与T0时相比,3D射血分数(3D EF)、3D收缩末期容积(ESV)差异有统计学意义(P<0.05),B组中病例组T4、T6时与T0时相比,3D EF差异有统计学意义(P<0.05);A组中T4、T6时与T0时相比,3D GLS、整体圆周应变(GCS)、整体面积应变(GAS)、整体径向应变(GRS)差异有统计学意义(P<0.05);B组T2、T4、T6时与T0时相比,3D GLS、GAS、GRS差异有统计学意义(P<0.05);B组T4、T6时与T0时相比,3D GCS差异有统计学意义(P<0.05)。上述各参数随化疗周期整体均呈下降趋势。T2时3D GLS、3D GAS在A、B两组中差异有统计学意义(P<0.05)。结论:左室压力应变环联合三维斑点追踪技术可以评价乳腺癌化疗患者早期心脏损害,年龄较大的患者心脏损伤早于年轻患者,需密切关注及早期干预。Objective:The left ventricular pressure-strain loop combined with 3D STI technique was used to evaluate the changes in left ventricular systolic function in breast cancer patients receiving anthracycline chemotherapy,explore the value of the two techniques in early clinical detection of chemotherapy-induced heart injury,and compare the difference of heart injury in different age groups.Methods:From December 2020 to January 2022,54 patients diagnosed with breast cancer by core needle puncture biopsy from breast surgery and oncology group of the First Hospital of Bethune,Jilin University were selected and divided into two groups according to different ages:age40 years old(group A),age≥40 years old(group B),left ventricular ejection fraction(LVEF)before chemotherapy55%,respectively(T0)prior to chemotherapy,echocardiography was performed after 2 cycles of chemotherapy(T2),4 cycles of chemotherapy(T4)and 6 cycles of chemotherapy(T6).At the same time,27 female patients matched in age for routine physical examination were selected as the control group.Common two-dimensional and three-dimensional parameters,left ventricular myocardial work parameters and 3D STI parameters were analyzed and the relevant indexes were obtained.Results:Compared with cases T4 and T6 in group A,the global longitudinal strain(GLS)of the left ventricle and the global work index(GWI)and global effective work(GCW)were statistically significant(P0.05).In group B,GCW at T2 was significantly different from that at T0(P0.05).In group B,GLS,GWI and GCW in T4 and T6were significantly different from those in T0(P0.05).3D EF and 3D end-systolic volume(ESV)in group A were significantly different from T6 in group A compared with T0 in group A(P0.05).Compared with T0 in group B,T4 and T6 in group B,the difference of 3D EF was statistically significant(P0.05).Global circumferential strain(GCS),global circumferential strain(GAS),and global radial strain(GRS)had statistically significant differences(P0.05).Compared with T0 at T2,T4 and T6 in group B,there wer

关 键 词：乳腺肿瘤 心室功能 左 超声检查 

分 类 号：R737.9[医药卫生—肿瘤] R322.11[医药卫生—临床医学] R445.1