应变率成像评价蒽环类抗肿瘤药物对乳腺癌患者右心室功能的影响

摘要
图/表
参考文献(20)
相关文章 (15)

全文: PDF (410 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨应变率显像技术对蒽环类化疗药物致乳腺癌患者右心室功能影响的评价作用。方法选取2015年10月~2016年10月在河北北方学院附属第一医院经病理确诊、采用CAF化疗方案的80例女性乳腺癌患者。所有研究对象采取自身对照的方式，分别于化疗前1 d及每次化疗周期的第5天获取常规超声心动图参数及应变率数据。结果在第6个化疗周期后，受试者的三尖瓣瓣环收缩期位移低于化疗前，右心室心肌功能指数高于化疗前（P < 0.05）。应变/应变率显像发现，与治疗前相比，乳腺癌患者蒽环类药物化疗第6周期后整体径向应变、整体长轴应变率及整体圆周应变显著下降（P < 0.05）。结论应变率成像能够早期反映蒽环类药物致乳腺癌患者右心室功能的改变。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	刘俊峰刘伟亮陆海永陈云璇温德惠王义成郜新春

关键词 ：应变率成像, 蒽环类药物, 乳腺癌, 右心室功能

Abstract：Objective To investigate the value of strain rate imaging for assessing the effect of anthracycline on right ventricular function in women with breast cancer. Methods From October 2015 to October 2016, 80 women pathologically diagnosed as breast cancer and undergoing CAF chemotherapy protocol at the First Affiliated Hospital of Hebei North University were recruited in this study. By the way of self-control, conventional echocardiography and strain rate imaging were performed to assess the right ventricular function at the first day before starting chemotherapy and the fifth day of every 5 chemotherapy cycles. Results The tricuspid annular plane systolic excursion was significantly lower, while the right ventricular myocardial performance index was significantly higher in women after the sixth cycles of chemotherapy compared with those before chemotherapy (P < 0.05). Strain rate imaging showed that global longitudinal strain rate, global radial strain and global circumferential strain in women after the sixth cycle of chemotherapy were significantly lower than those before chemotherapy(P < 0.05). Conclusion Strain rate imaging can reflect the change of right ventricular function at an early stage in breast cancer women treated with anthracycline.

Key words： Strain rate imaging Anthracycline Breast cancer Right ventricular function

基金资助:河北省医学科学研究重点课题计划（20160360）。

引用本文:

刘俊峰刘伟亮陆海永陈云璇温德惠王义成郜新春. 应变率成像评价蒽环类抗肿瘤药物对乳腺癌患者右心室功能的影响[J]. 中国医药导报, 2018, 15(23): 84-87.
LIU Junfeng LIU Weiliang LU Haiyong CHEN Yunxuan WEN Dehui WANG Yicheng GAO Xinchun. Effect of anthracycline on right ventricular function assessed by strain rate imaging in women with breast cancer. 中国医药导报, 2018, 15(23): 84-87.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I23/84

[1] Menting ME，Mcghie JS，Koopman LP，et al. Normal myocardial strain values using 2D speckle tracking echocardiography in healthy adults aged 20 to 72 years [J]. Echocardiography，2016，33（11）：1665-1675.
[2] 宋飞艳，程蕾蕾.超声心动图监测淋巴瘤患者蒽环类药物化疗后右心室亚临床功能减退的应用[J].复旦学报：医学版，2016，43（2）：231-235.
[3] 林剑英，李涛，陈茹，等.应变率成像检测肿瘤患者蒽环类药物化疗后心脏毒性的研究[J].临床超声医学杂志，2010，12（5）：309-312.
[4] Moustafa S，Ho TH，Shah P，et al. Predictors of incipient dysfunction of all cardiac chambers after treatment of metastatic renal cell carcinoma by tyrosine kinase inhibitors [J]. J Clin Ultrasound， 2016，44（4）：221-230.
[5] Rudski LG，Lai WW，Afilalo J，et al. Guidelines for the echocardiographic assessment of the right heart in adults：a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography，a registered branch of the European Society of Cardiology，and the Canadian Society of Echocardiography [J]. J Am Soc Echocardiogr，2010，23（7）：685-713.
[6] Ferlay J，Shin HR，Bray F，et al. GLOBOCAN 2008，cancer incidence and mortality worldwide：IARC CancerBase No.10 [R]. Lyon，France：International Agency for Research on Cancer，2010：29.
[7] 石建伟，唐智柳，蔡美玉，等.2008～2012年我国女性乳腺癌流行状况的系统性综述[J].中国妇幼保健，2014，29（10）：1622-1626.
[8] 孔嘉欣，苏旭春，戴诗蕾，等.黄芪多糖防治蒽环类药物心脏毒性的临床观察[J].中国医药导报，2017，14（20）：136-139.
[9] Vulsteke C，Pfeil AM，Maggen C，et al. Clinical and genetic risk factors for epirubicin-induced cardiac toxicity in early breast cancer patients [J]. Breast Cancer Res Treat，2015，152（1）：67-76.
[10] 王淑琴，陆红，李玲玲.应变率成像技术评价蒽环类化疗药物对乳腺癌患者心功能影响[J].山东医药，2008， 48（32）：71-72.
[11] 薛继平，苏莉莉，康春松，等.斑点追踪技术评价蒽环类药物对乳腺癌患者左心室跨壁力学的影响[J].中华超声影像学杂志，2015，24（12）：1033-1038.
[12] 李倩倩，姜志荣，王小凡，等.二维斑点追踪成像评价蒽环类化疗药物剂量对乳腺癌患者左心室功能的影响[J].心脏杂志，2014，26（1）：56-59.
[13] Tan C，OuYang M，Kong D，et al. Association between the left atrial and left atrial appendages systole strain rate in patients with atrial fibrillation [J]. Med Sci Monit，2016， 22：4974-4977.
[14] Kaneko S，Tham EB，Haykowsky MJ，et al. Impaired left ventricular reserve in childhood cancer survivors treated with anthracycline therapy [J]. Pediatr Blood Cancer，2016，63（6）：1086-1090.
[15] Sutherland GR，Di Salvo G，Claus P，et al. Strain and strain rate imaging：a new clinical approach to quantifying regional myocardial function [J]. J Am Soc Echocardiogr，2004，17（7）：788-802.
[16] Lo Q，Hee L，Batumalai V，et al. Strain imaging detects dose-dependent segmental cardiac dysfunction in the acute phase after breast irradiation [J]. Int J Radiat Oncol Biol Phys，2017，99（1）：182-190.
[17] 舒先红，黄国倩，潘翠珍，等.正常人心肌应变及应变率定量分析[J].中华超声影像学杂志，2004，13（11）：4-6.
[18] Soyama Y，Mano T，Goda A，et al. Prognostic value of diastolic wall strain in patients with chronic heart failure with reduced ejection fraction [J]. Heart Vessels，2017， 32（1）：68-75.
[19] Baysal T，Koksal Y，Oran B，et al. Cardiac functions evaluated with tissue doppler imaging in childhood cancers treated with anthracycline [J]. Chin J Contemp Pediatr，2011，13（6）：490-494.
[20] Yagci-Kupeli B，Varan A，Yorgun H，et al. Tissue doppler and myocardial deformation imaging to detect myocardial dysfunction in pediatric cancer patients treated with high dose of anthracyclines [J]. Asia Pac J Clin Oncol，2012，8（4）：368-374.