基于Tei指数评价蒽环类药物对急性白血病患儿心脏毒性的研究  

Evaluation of Cardiac Toxicity of Anthracyclines in Children with Acute Leukemia Based on Tei Index

作　　者：陈雪梅[1] 郭品[2] 钏刘芳 王梓[3] 李雪娇[2] 何文姬[2] Xuemei CHEN;Pin GUO;Liufang CHUAN;Zi WANG;Xuejiao LI;Wenji HE(The Third Affiliated Hospital of Kunming Medical University/Yunnan Cancer Hospital Clinical Research Department of National Institute for Drug Clinical Trials(GCP office),Kunming Yunnan 650118;Dept.of Ultrasound/Cardiac Function,Kunming Children’s Hospital,Kunming Medical University/Kunming Children’s Hospital,Kunming Yunnan 650228;Dept.of Clinical Medicine,Affiliated Hospital of Yunnan University,Kunming Yunnan 650051,China)

机构地区：[1]昆明医科大学第三附属医院/云南省肿瘤医院国家药物临床试验机构临床研究部(GCP办公室),云南昆明650118 [2]昆明医科大学附属儿童医院超声科/心功能科,云南昆明650228 [3]云南大学附属医院临床药学部,云南昆明650021

出　　处：《昆明医科大学学报》2024年第2期117-122,共6页Journal of Kunming Medical University

基　　金：春城名医项目(20220021);云南省卫健委医学后备人才培养计划(H-2018012);云南省教育厅科学研究基金资助项目(2018JS244)。

摘　　要：目的应用超声技术监测急性白血病患儿使用蒽环类药物后的心功能,以期得到心功能早期变化的指标。方法按照入组与排除标准选取2018年3月至2020年12月昆明医科大学附属儿童医院白血病患儿,记录其常规心脏超声指标和组织多普勒,并应用TeiS、TeiRL、TeiM和TeiT评估心脏收缩功能的变化。结果正常组和用药前实验组常规心脏超声指标中LVEF的均值都在60%以上,FS、SV及EDV均在正常范围,常规指标、TDI和Tei指数无统计学意义(P>0.05);实验组累积剂量为200和250 mg/m^(2)组的TeiM与用药前存在显著差异(P<0.05);200和250 mg/m^(2)组与用药前的TeiRL存在显著差异(P<0.05);200和250 mg/m^(2)组与用药前的TeiT存在显著差异(P<0.05)。结论Tei指数可作为白血病患儿应用蒽环类药物后左右心功能的早期改变较敏感监测指标。Objective To apply ultrasound to monitor cardiac function changes after anthracycline exposure in children with acute leukemia,in order to obtain the indicators of early changes in their cardiac function.Methods Children with acute leukemia from 2018 March to December 2020 in the Children’s Hospital of Kunming Medical University were enrolled according to the inclusion and exclusion criteria,their routine cardiac ultrasound and tissue Doppler condition were recorded,and the changes in systolic function were evaluated by Tei index including TeiS,TeiRL,TeiM and TeiT.Results The mean values of LVEF in the normal and the experimental group were both above 60%.FS,SV,and EDV were all in the normal range.While common indicant,the index of TDI or Tei was not statistically significant(P>0.05).The levels of TeiM,TeiRL and TieT in the groups that received a total dose of 200 mg/m^(2) anthracyclines and 250 mg/m^(2) were significantly different from that before treatment(P<0.05).Conclusion Tei index can be utilized as a sensitive indicator for early changes in left and right heart function after children with acute leukemia are exposed to anthracyclines.

关 键 词：蒽环类药物 心脏毒性 超声心动图 室间隔基底段心肌做功指数 右室侧壁基底心肌做功指数 左心心肌做功指数 

分 类 号：R459.9[医药卫生—治疗学]