摘要
目的探讨超声心动图多模态技术在评价动态监测肿瘤化疗所致心脏毒性中的应用效果。方法选择2018年1月至2021年1月郑州市第七人民医院就诊的化疗患者38例(化疗组),同期选择健康志愿者40例为对照组,所有化疗患者分别在化疗2、4、6周期后采用三维斑点追踪技术(3D-STI)、实时二维超声心动图(RT-2DE)、超声造影(CEUS)及组织多普勒成像(TDI)方法分别检测心功能。观察两组的左心室射血分数(LVEF)、E峰、A峰、短轴缩短率(FS)、E/A,E峰减速时间(DT)、左心室整体圆周应变(LVGCS)、左心室整体径向应变(LVGRS)、左心室整体纵向应变(LVGLS)、左心室扭转角度峰值(LVPtw)、左心室扭矩(LVTor)、舒张末期左心室内径(LVED)、左房前后径(LAD)等。结果TDI检查结果显示,化疗组中,化疗2、4、6周期后三个周期检测的FS、E/A、DT的差异均有统计学意义(均为P<0.05);与对照组比较,化疗6周期后检测的FS、E/A的差异均有统计学意义(均为P<0.05)。3D-STI检查结果显示,化疗组中,化疗2、4、6周期后三个周期检测的LVGCS、LVGLS、LVPtw、LVTor的差异均有统计学意义(均为P<0.05);与对照组比较,化疗6周期后检测的LVGCS、LVGLS、LVPtw、LVTor的差异均有统计学意义(均为P<0.05);CEUS检查结果显示,化疗组中,化疗2、4、6周期后三个周期检测的LVED、LAD、LVEF水平和间隔E/A<1比例的差异均有统计学意义(均为P<0.05);与对照组比较,化疗6周期后检测的LVED、LAD、LVEF水平和间隔E/A<1比例的差异均有统计学意义(均为P<0.05)。结论蒽环类药物化疗会导致心脏毒性,3D-STI、CEUS及TDI能检测到化疗后所致的心脏毒性。
Objective To investigate the application effect of cardiac ultrasound multimodality technology in the evaluation of dynamic monitoring of cardiotoxicity induced by tumor chemotherapy.Methods A total of 38 chemotherapy patients(chemotherapy group)admitted to the 7th People’s Hospital of Zhengzhou from January 2018 to January 2021 were included,and 40 healthy volunteers were also selected as the control group.All patients in the chemotherapy group performed cardiac function examination by three-dimensional speckle tracking(3D-STI),real-time two-dimensional echocardiography(RT-2DE),contrast-enhanced ultrasound(CEUS)and tissue Doppler imaging(TDI)after 2,4 and 6 cycles of chemotherapy.Cardiac function parameters,including left ventricular ejection fraction(LVEF),E peak,A peak,short axis shortening rate(FS),E/A,E peak deceleration time(DT),LV global circumferential strain(LVGCS),global radial strain(LVGRS),global longitudinal strain(LVGLS),peak left ventricular torsion angle(LVPtw),left ventricular torque(LVTor)and left atrial diameter(LAD)were compared between the two groups.Results TDI examination showed that in the chemotherapy group,the differences in FS,E/A and DT detected after the 2,4 and 6 cycles of chemotherapy were all statistically significant(all P<0.05).Meanwhile,compared with the control group,patients in the chemotherapy group were associated with statistically significant different levels of FS and E/A detected after 6 cycles of chemotherapy(both P<0.05).3D-STI examination showed that in the chemotherapy group,the differences in LVGCS,LVGLS,LVPtw,and LVTor were statistically significant among the 2,4,and 6 cycles of chemotherapy(all P<0.05).Moreover,the differences in LVGCS,LVGLS,LVPtw and LVTor detected after 6 cycles of chemotherapy were all statistically significant compared to those in the control group(all P<0.05).CEUS examination indicated that there were significant differences in the levels of LVED,LAD,LVEF and the ratio of interval E/A<1 among the 2,4 and 6 cycles of chemotherapy(all P<0.05)
作者
贾娟
于慧娟
黄蕾
焦方杰
浮志坤
Jia Juan;Yu Huijuan;Huang Lei;Jiao Fangjie;Fu Zhikun(Department of Ultrasound Imaging,The 7th People’s Hospital of Zhengzhou,Zhengzhou 450016,China;Department of Cardiology,The 7th People’s Hospital of Zhengzhou,Zhengzhou 450016,China)
出处
《中国心血管杂志》
2022年第4期325-330,共6页
Chinese Journal of Cardiovascular Medicine
基金
2018年度河南省医学科技攻关计划项目(2018020861)。
关键词
三维斑点追踪技术
实时二维超声心动图
超声造影
组织多普勒成像
肿瘤
化疗
心脏毒性
Three-dimensional speckle tracking
Real-time two-dimensional echocardiography
Contrast-enhanced ultrasound
Tissue Doppler imaging
Tumor
Chemotherapy
Cardiotoxicity
