斑点追踪成像技术评估黄芪甲苷对表柔比星大鼠心脏毒性的影响  

Evaluate the effect of astragalosideⅣon epirubicin cardiotoxicity in rats using speckle tracking imaging

作　　者：栾丽娜 陈海燕 李正[3] 刘阳 舒先红 LUAN Lina;CHEN Haiyan;LI Zheng;LIU Yang;SHU Xianhong(Department of Echocardiography,Shanghai Geriatric Medical Center,Shanghai 201104,China;Department of Echocardiography,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Research Center,Institute of Clinical Science,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]上海市老年医学中心心脏超声诊断科,上海201104 [2]复旦大学附属中山医院心脏超声诊断科,上海200032 [3]复旦大学附属中山医院临床医学研究院实验研究中心,上海200032

出　　处：《肿瘤影像学》2025年第1期30-36,共7页Oncoradiology

基　　金：国家自然科学基金项目(82227803)。

摘　　要：目的:表柔比星(epirubicin,Epb)是治疗恶性肿瘤的有效药物,但具有心脏毒性。本研究旨在应用斑点追踪成像技术评估黄芪甲苷(astragalosideⅣ,AS-Ⅳ)对Epb诱导大鼠心肌损伤的保护作用。方法:将32只SD大鼠随机分为正常对照组、Epb模型组、低剂量AS-Ⅳ组和高剂量AS-Ⅳ组,每组8只。所有大鼠于治疗前及治疗后2周、4周、6周行经胸超声心动图(transthoracic echocardiography,TTE)监测,获取左心室射血分数(left ventricular ejection fraction,LVEF)及左心室整体纵向应变(global longitudinal strain,GLS)参数。于第6周处死大鼠,取血清检测CK-MB、LDH及IL-17,心脏取材行Masson染色。结果:组别主效应、时间主效应及两者交互效应对LVEF的影响差异均无统计学意义(P>0.05)。组别主效应、时间主效应对GLS值的影响均具有高度显著性[F组别(3,21)=11.0142,P<0.0001,F时间(3,21)=7.2154,P=0.0017],两者交互效应接近显著[F交互(9,63)=1.8761,P=0.0720];各组大鼠血清学指标CK-MB、LDH差异无统计学意义(P>0.05);IL-17水平差异有统计学意义:Epb模型组IL-17水平较正常对照组显著升高,低剂量及高剂量AS-Ⅳ组IL-17水平相仿,较Epb模型组显著降低(P<0.05);各组心脏重量指数差异无统计学意义,纤维化面积百分比具有显著组间差异,纤维化程度由轻到重依次为正常对照组、高剂量治疗组、低剂量治疗组及Epb模型组(P<0.0001)。结论:AS-Ⅳ可能通过抑制炎症减轻心肌纤维化,改善Epb相关的心肌损伤。GLS能较LVEF更为敏感准确地识别亚临床心肌损伤。Objective:To evaluate the protective effects of astragalosideⅣ(AS-Ⅳ)against epirubicin(Epb)-induced cardiac injury in rats using speckle tracking imaging.Methods:Thirty-two SD rats were randomly assigned to four groups(n=8 per group):normal control,Epb model,low-dose AS-Ⅳ,and high-dose AS-Ⅳ.Transthoracic echocardiography(TTE)was performed at baseline and at 2,4,and 6 weeks post-treatment to assess left ventricular ejection fraction(LVEF)and global longitudinal strain(GLS).At week 6,serum levels of CK-MB,LDH,and IL-17 were measured,and heart tissues were collected for Masson staining to evaluate myocardial fibrosis.Results:LVEF showed no significant changes across groups or over time(P>0.05).GLS,however,was significantly influenced by both factors[F group(3,21)=11.0142,P<0.0001]and time[F time(3,21)=7.2154,P=0.0017],with a near-significant interaction effect[F interaction(9,63)=1.8761,P=0.0720].Serum CK-MB and LDH levels showed no significant differences among groups(P>0.05).IL-17 levels were significantly elevated in the Epb model group compared to the control group,while both AS-Ⅳtreatment groups exhibited significantly reduced levels compared to the Epb model group(P<0.05).The heart weight index did not differ significantly among groups,but myocardial fibrosis area showed significant variations,worsening progressively from control to high-dose AS-Ⅳ,low-dose AS-Ⅳand Epb model groups(P<0.0001).Conclusion:AS-Ⅳmay attenuate myocardial fibrosis and reduce inflammation in Epb-induced myocardial damage.GLS proved to be a more sensitive and accurate indicator than LVEF for detecting subclinical myocardial injury.

关 键 词：黄芪甲苷 心脏毒性 表柔比星 斑点追踪成像 经胸超声心动图 

分 类 号：R445.1[医药卫生—影像医学与核医学]