摘要
目的探究蒽环类药物化疗对乳腺癌患者左心室收缩同步性影响的峰值应变离散度评估效果。方法选取2017年6月-2019年6月我院收治的乳腺癌患者128例为观察组,并以同期在我院进行健康检查的健康志愿者128例为对照组。两组对象均测量常规超声心动图参数,并计算左心室射血分数(LVEF)和左心室质量指数(LVMI)。使用Echopac201.54软件获得18节段收缩期纵向应变达峰时间(TTPLS)牛眼图、纵向峰值应变离散度(PSD)和纵向峰值应变(LPS),并计算左心室不同步节段个数(LVDSN)和左心室纵向应变达峰时间极差值(TTPLSR)。比较两组研究对象常规超声心动图以及观察组患者化疗前后左心室PSD、TTPLSR、LPS与18节段LVDSN水平,并分析左心室PSD、TTPLSR、LPS与18节段LVDSN对乳腺癌患者左心室收缩同步性的诊断效能。结果观察组患者左心室后壁舒张末期厚度(LVPWd)、室间隔舒张末期厚度(IVSd)、左心室舒张末期内径(LVDd)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)和LVMI均显著高于对照组(P<0.05),LVEF显著低于对照组(P<0.05)。化疗前,观察组患者左心室PSD、TTPLSR与18节段LVDSN水平均显著高于对照组(P<0.05),LPS显著低于对照组(P<0.05);化疗后,观察组患者左心室PSD、TTPLSR与18节段LVDSN水平均显著低于化疗前,LPS水平显著高于化疗前(P<0.05)。PSD、TTPLSR、LPS与18节段LVDSN对乳腺癌患者左心室收缩同步性的敏感度和特异度均较高,具有较好的诊断价值。结论蒽环类药物化疗可诱导乳腺癌患者左心室节段收缩期延长,导致PSD、TTPLSR、LVDSN降低,LPS升高,监测上述指标可有效诊断左心室收缩同步性,以便积极采取有效措施,改善患者预后。
Objective To investigate the diagnostic value of peak strain dispersion on anthracyeline-affected left ventricular systolic synchrony of breast cancer patients.Methods A total of 128 breast cancer patients admitted to our hospital between June 2016 and June 2019 were enrolled in the observation group.128 healthy volunteers who came to our hospital for health examination during the same period were selected as the control group.Routine echocardiographic parameters were measured for both groups,and left ventricular ejection fraction(LVEF)and left ventricular mass index(LVM1)were calculated.The bull’s eyes of left ventricular 18-segment systolic time to peak longitudinal strain(TTPLS),and the longitudinal peak strain dispersion(PSD)and longitudinal peak strain(LPS)were acquired by Echopac201.54 software.The number of left ventricular dyssynchrony segments(LVDSN)and the range of left ventricular time to peak longitudinal strain(TTPLSR)were calculated.Compare the conventional echocardiography between the observation group and control group,observe the left ventricular PSD,TTPLSR,LPS and 18-segment LVDSN before and after chemotherapy,and analyze the efficacy of left ventricular PSD,TTPLSR,LPS and 18-segment LVDSN in diagnosing left ventricular systolic synchrony for breast cancer patients.Results Left ventricular end-diastolic posterior wall thickness(LVPWd),inter-ventricular septum end-diastolic thickness(IVSd),left ventricular end-diastolic diameter(LVDd),left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV)and LVMI of the observation group were all higher than those of the control group(P<0.05).And the LVEF of the observation group was lower than that of the control group(P<0.05).Before chemotherapy,the left ventricular PSD,TTPLSR and 18-segment LVDSN were significantly higher in observation group than in control group(P<0.05),and the LPS was lower in observation group than in control group(P<0.05).After chemotherapy,the left ventricular PSD,TTPLSR and 18-segment LVDSN in the obs
作者
周恕敏
罗悦琼
ZHOU Shumin;LUO Yueqiong(Ultrasonic Department,Jianyang Chinese Medicine Hospital,Jianyang,Sichuan,641400,China;Oncology Department,Jianyang Chinese Medicine Hospital,Jianyang,Sichuan,641400,China)
出处
《肿瘤药学》
CAS
2020年第1期77-81,86,共6页
Anti-Tumor Pharmacy
关键词
乳腺癌
蒽环类
化疗
左心室收缩同步
峰值应变离散度
Breast cancer
Anthracycline
Chemotherapy
Left ventricular systolic synchrony
Peak strain dispersion
