2D-STI联合肌酸激酶监测乳腺癌蒽环类药物化疗后心脏毒性的价值  

作　　者：倪成香 蔡洁[1] 胡国梁[1] 范霜月 

机构地区：[1]浙江省金华市人民医院,321000

出　　处：《浙江临床医学》2024年第5期752-754,共3页Zhejiang Clinical Medical Journal

基　　金：金华市科学技术研究计划项目(2021-4-066)。

摘　　要：目的探讨二维斑点追踪显像(2D-STI)联合血清肌酸激酶(CK)检测在乳腺癌蒽环类药物化疗后心脏毒性监测中的应用价值。方法选取2021年2月至2023年2月接受蒽环类药物化疗的乳腺癌患者102例,化疗周期结束后根据心电图检查结果分组,正常组72例,异常组30例。另选取同期健康女性体检者34例作为健康组。在化疗前后分别检测血清CK,并行2D-STI检查,记录左心室应变参数。结果化疗后异常组血清CK水平高于正常组(P<0.05),异常组GLS低于正常组(P<0.05)。血清CK评估化疗后心脏毒性反应的敏感度为76.67%,特异度为83.33%。2D-STI参数GLS评估化疗后心脏毒性反应的敏感度为83.33%,特异度为72.22%。联合检测的敏感度为96.67%,特异度为70.83%。ROC曲线分析结果显示,GLS、血清CK及其联合检测化疗后心脏毒性的AUC值分别为0.835、0.820及0.895。结论2D-STI联合血清CK对监测乳腺癌蒽环类药物化疗后心脏毒性反应有重要价值,化疗后心脏毒性可引起血清CK水平升高,左心室心肌应变异常。Objective To investigate the application value of two-dimensional speckle tracking imaging(2D-STI)combined with serum creatine kinase(CK)in monitoring cardiotoxicity after anthracycline chemotherapy for breast cancer.Methods 102 breast cancer patients who underwent anthracycline chemotherapy in the hospital between February 2021 and February 2023 were selected.After the end of chemotherapy,patients enrolled were divided into the normal group(72 cases)and the abnormal group(30 cases)according to whether the electrocardiogram was normal or not.Meanwhile,34 healthy women were selected as the healthy group.Serum CK was detected,and 2D-STI was performed before and after chemotherapy.The left ventricular strain parameters global longitudinal strain(GLS)were recorded.Results After chemotherapy,serum CK level of the abnormal group was higher than that of the normal group(P<0.05).The GLS of the abnormal group were lower than those of the normal group(P<0.05).The sensitivity and specificity of serum CK to evaluate cardiotoxicity after chemotherapy were 76.67%and 83.33%.The sensitivity and specificity of GLS to evaluate cardiotoxicity after chemotherapy were 83.33%and 72.22%.The sensitivity of joint detection was 96.67%and the specificity was 70.83%.The results of ROC curve analysis showed that the AUC values of GLS,serum CK and their combination in detecting cardiotoxicity after chemotherapy were 0.835,0.820 and 0.895,respectively.Conclusion 2D-STI combined with serum CK is of great value in monitoring cardiotoxicity after anthracycline chemotherapy for breast cancer.Cardiotoxicity after chemotherapy will cause increase in serum CK level and abnormality of left ventricular myocardial strain.

关 键 词：乳腺癌 蒽环类药物 化疗 心脏毒性 二维斑点追踪显像 肌酸激酶 

分 类 号：R737.9[医药卫生—肿瘤]