人表皮生长因子受体2阳性乳腺癌曲妥珠单抗联合化学治疗过程中心脏超声参数对心脏毒性的预测价值  

Cardiac ultrasound changes of trastuzumab combined with chemotherapy in patients with HER2-positive breast cancer and thier relationship with cardiotoxicity

作　　者：陈蕾 洪春霞 王佳莉 Chen Lei;Hong Chunxia;Wang Jiali(Department of Pharmacy,Jinhua Central Hospital,Jinhua,Zhejiang 321000,China)

机构地区：[1]金华市中心医院药学部,浙江金华321000

出　　处：《中国药物与临床》2025年第5期289-294,共6页Chinese Remedies & Clinics

摘　　要：目的探究人表皮生长因子受体(HER)2阳性乳腺癌患者曲妥珠单抗联合化疗过程中心脏超声变化及与心脏毒性发生的关系。方法选取2020年9月至2022年4月浙江省金华市中心医院收治的91例HER2阳性乳腺癌患者接受曲妥珠单抗联合化疗,按是否发生心脏毒性分为心脏毒性组(18例)与无心脏毒性组(73例),比较心脏超声参数,分析其对心脏毒性发生的预测价值。结果治疗3、6、12个周期左室射血分数(LVEF)低于无心脏毒性组,整体面积应变(GAS)高于无心脏毒性组,治疗12个周期,左房容积指数(LAVI)、整体径向应变(GRS)高于无心脏毒性组,治疗6、12个周期整体纵向应变(GLS)、整体圆周应变(GCS)高于无心脏毒性组(P<0.05);Logistic回归分析显示LVEF、LAVI、GLS预测HER2阳性乳腺癌患者心脏毒性发生的预测价值较高(OR=0.325、3.536、4.486,P<0.05)。结论曲妥珠单抗联合化疗出现心脏毒性的HER2阳性乳腺癌患者LVEF降低,左室应变参数改变,可预测心脏毒性发生。Objective To investigate the changes in cardiac ultrasound and the relationship with the oc-currence of cardiotoxicity in human epidermal growth factor receptor(HER)2-positive breast cancer patients treat-ed with trastuzumab combined with chemotherapy.Methods Ninety-one HER2-positive breast cancer patients in Jinhua Central Hospital from September 2020 to April 2022 receiving trastuzumab combined with chemotherapy were divided into a cardiotoxicity group(18 cases)and a non-cardiotoxicity group(73 cases)according to whether cardiotoxicity occurred or not.Cardiac ultrasound parameters were compared to analyze their predictive value of the occurrence of cardiotoxicity.Results LVEF was lower than that of the non-cardiotoxic group but GAS was higher than that of the non-cardiotoxic group after 3,6 and 12 cycles of treatment(P<0.05).LAVI and GRS were higher than that of the non-cardiotoxic group after 12 cycles of treatment,and GLS and GCS were higher than that of the non-cardiotoxic group after 6 and 12 cycles of treatment(P<0.05).Logistic regression analysis of LVEF,LAVI and GLS predicted the HER2-positive breast cancer patients with high predictive value for the occurrence of cardiotoxicity(OR=0.325,3.536,4.486,all P<0.05).Conclusion HER2-positive breast cancer patients who devel-oped cardiotoxicity with trastuzumab combined with chemotherapy show reduced LVEF and improved left ventric-ular strain parameters,which can predict cardiotoxicity.

关 键 词：人表皮生长因子受体2 乳腺肿瘤 曲妥珠单抗 心脏毒性 

分 类 号：R737.9[医药卫生—肿瘤]