二维斑点追踪技术联合右室量化分析系统评价淋巴瘤患者化疗后右室功能改变  

Evaluation of right ventricular function in patients with lymphoma after chemotherapy by two-dimensional speckle tracking imaging combined with quantitative analysis system of right ventricle

作　　者：练菲菲 刘表虎[1] 纪文艳 丁静 陶善强 杨优 LIAN Feifei;LIU Biaohu;JI Wenyan;DING Jing;TAO Shanqiang;YANG You(Department of Ultrasound,Yijishan Hospital,Wannan Medical College,Wuhu 241000,China)

机构地区：[1]皖南医学院弋矶山医院超声科,安徽芜湖241000

出　　处：《包头医学院学报》2024年第4期27-32,共6页Journal of Baotou Medical College

基　　金：国家自然科学基金(81670301);安徽省高等学校省级质量工程项目(2020xskt525,2020xsxxkc458)。

摘　　要：目的:应用二维斑点追踪技术(2D-STI)联合右室量化分析系统(QAS-R)评价淋巴瘤患者化疗后右室功能改变。方法:选取确诊淋巴瘤并接受蒽环类药物化疗患者40例。根据化疗周期分为化疗前(T0)、完成2个周期(T1)、完成4个周期(T2)及完成6个周期(T3)。常规超声心动图测量左室射血分数(LVEF)、三尖瓣环收缩期峰值流速(S’)、三尖瓣环收缩期位移(TAPSE)、右室面积变化分数(FAC)、三尖瓣环舒张早期峰值流速(E)、三尖瓣环舒张晚期峰值流速(A),计算E/A;二维斑点追踪技术测量右室游离壁基底段应变(Sb)、右室游离壁中间段应变(Sm)、右室游离壁心尖段应变(Sa),计算右室游离壁纵向应变(RVFWLS);右室量化分析系统测量右室射血分数(RVEF)。比较上述参数化疗前后差异。结果:与T0相比,LVEF、E/A在T1、T2和T3无明显差异(P>0.05);与T0相比,RVFWLS、Sb、Sm、RVEF在T1、T2、T3明显降低(P<0.05),Sa、RVFAC在T2、T3明显降低(P<0.05),TAPSE、S’在T3明显降低(P<0.05);与T1相比,RVFWLS、Sb、Sm、Sa、RVEF、FAC在T2、T3明显降低(P<0.05);TAPSE、S’在T3明显降低(P<0.05);与T2相比,RVFWLS、Sb、Sm、Sa、RVEF、TAPSE、FAC、S’在T3明显降低(P<0.05)。在相关性分析中,蒽环类药物累积剂量与RVFWLS、Sb、Sm、Sa、RVEF、RVFAC、TAPSE、S’呈负相关,相关系数分别为-0.775、-0.673、-0.628、-0.593、-0.749、-0.468、-0.368、-0.346;RVEF与RVFWLS、Sb、Sm、Sa、RVFAC、TAPSE、S’呈正相关,相关系数分别为0.667、0.597、0.491、0.544、0.354、0.258、0.257。结论:2D-STI联合QAS-R可以评价淋巴瘤患者化疗后右室功能改变。Objective:Two dimensional speckle tracking imaging(2D-STI)combined with quantitative analysis system of right ventricle(QAS-R)was used to evaluate the changes of right ventricular function in patients with lymphoma after chemotherapy.Methods:Forty patients with lymphoma diagnosed in the hematology department and receiving anthracycline chemotherapy were selected.According to the chemotherapy cycle,they were divided into pre chemotherapy(T0),completion of 2 cycles(T1),completion of 4 cycles(T2)and completion of 6 cycles(T3).Left ventricular ejection fraction(LVEF),tricuspid annular systolic peak flow velocity(S’),tricuspid annular plane systolic excursion(TAPSE),FAC(fractional area change),early diastolic peak velocity of tricuspid annulus(E),late diastolic peak velocity of tricuspid annulus(A)were measured by conventional echocardiography,and E/A was calculated.Two dimensional speckle tracking imaging was used to measure strain of the base segment of the right ventricular free wall(Sb),strain of the middle segment of the right ventricular free wall(Sm),strain of the apex segment of the right ventricular free wall(Sa),and calculate longitudinal strain of the right ventricular free wall(RVFWLS).Right ventricular ejection fraction(RVEF)was measured by quantitative analysis system of right ventricle.The differences of the above parameters before and after chemotherapy were compared.Results:Compared with T0,LVEF and E/A had no significant difference in T1,T2 and T3(P>0.05);Compared with T0,RVFWLS,Sb,Sm and RVEF decreased significantly in T1,T2 and T3(P<0.05);Sa and RVFAC decreased significantly in T2 and T3(P<0.05);TAPSE and S’decreased significantly in T3(P<0.05);Compared with T1,RVFWLS,Sb,Sm,Sa,RVEF and FAC decreased significantly in T2 and T3(P<0.05);TAPSE and S’decreased significantly in T3(P<0.05);Compared with T2,RVFWLS,Sb,Sm,Sa,RVEF,TAPSE,FAC,S’in T3 decreased significantly(P<0.05).In the correlation analysis,the cumulative dose of anthracyclines was negatively correlated with RVFWLS,Sb,Sm,Sa,RVEF,RVFAC

关 键 词：淋巴瘤 蒽环类药物 二维斑点追踪技术 右室量化分析系统 右室功能 

分 类 号：R733.1[医药卫生—肿瘤] R540.45[医药卫生—临床医学]