应变超声心动图早期检测蒽环类药物诱导的急性淋巴细胞白血病患儿左心室功能障碍  

Strain echocardiography detecting left ventricular dysfunction in children with acute lymphocytic leukemia induced by anthracycloids

作　　者：谢艳林 董燕 李翠玲 董盖英 XIE Yanlin;DONG Yan;LI Cuiling;DONG Gaiying(Department of ultrasound,Guanghzhou First People’s Hospital,Second Affiliated Hospital,School of Medicine,South China University of Technology,Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院(华南理工大学附属第二医院)超声医学科,广东广州510180

出　　处：《广州医药》2024年第11期1308-1313,共6页Guangzhou Medical Journal

摘　　要：目的探讨常规超声心动图联合二维斑点追踪技术评估急性白血病患儿在接受蒽环类药物治疗后产生的心脏毒性,早期检测左心功能障碍。方法采用前瞻性非随机观察研究,选取新诊断急性淋巴细胞白血病患儿20例,分别于确诊白血病后接受蒽环类药物治疗前、接受所有蒽环类药物剂量后以及确诊白血病1年后,进行常规超声心动图和二维斑点技术监测评估心脏毒性。结果左室流出道速度积分TVI和E、E/E’在治疗期间下降,并在诊断后1年恢复至治疗前数值。在二维斑点追踪纵向应变中,GLPS-LAX、GLPS-A2C、LV-GLPS在完成所有蒽环类药物剂量后与诊断后比较差异有统计学意义,以及诊断后1年与蒽环类药物治疗后比较差异有统计学意义。但GLPS-A4C各时间点比较差异无统计学意义。结论常规超声心动图联合二维斑点追踪技术的纵向整体应变可早期发现白血病患儿化疗所致的左室功能障碍。Objective To evaluate cardiotoxicity in children with acute lymphoblastic leukemia treated with anthracyclines by echocardiography combined with 2D speckle tracking imaging,and to detect left heart dysfunction early.Methods In this prospective nonrandomized study,20 children with newly diagnosed acute lymphoblastic leukemia were assessed for cardiotoxicity by echocardiography and 2D speckle tracking imaging in three periods during the treatment.Results The left ventricular outflow tract velocity integral TVI and E,E/E’decreased during treatment,and went back to the pre-treatment value one year after diagnosis.In the longitudinal strain of 2D speckle tracking imaging,in GLPS-LAX,GLPS-A2C,LV-GLPS,there were statistical differences between treatment completed and after diagnosis,and between 1 year after diagnosis and treatment completed.However,GLPSA4C has no statistical significance.Conclusions The conventional echocardiography combined with longitudinal overall strain of 2D speckle tracking imaging can comprehensively evaluate the early changes of left ventricular dysfunction caused by chemotherapy in children with leukemia.

关 键 词：斑点追踪技术 白血病 蒽环类药物 心脏毒性 

分 类 号：R540.45[医药卫生—心血管疾病] R733.71[医药卫生—内科学]