二维彩色多普勒超声监测蒽环类抗肿瘤药对恶性肿瘤患者心脏毒性的诊断价值

Diagnostic value of two dimensional and color Doppler echocard iography in assessment of cardiotoxity in patients treated with anthracycline

目的探讨二维彩色多普勒超声在评价蒽环类抗肿瘤药(ATC)心脏毒性方面的应用价值。方法应用PhilipsSonos二维彩色多普勒超声测定83例接受ATC化疗的肿瘤患者及50例正常对照组的心脏内径和左室功能。结果左心室收缩功能参数和室间隔(IVS)及左室后壁(LVPW)的室壁增厚率(ΔT%)在ATC化疗组和对照组之间无显著性差异(P>0.05);但ATC化疗组中30例(36%)患者出现左心室舒张功能指标异常,其中E/A明显低于对照组;心功能参数与ATC累积剂量、距首次化疗时间及相应节段的室壁增厚率均无显著相关性。结论二维彩色多普勒超声检测技术可作为评价ATC早期心脏毒性的手段之一。

Objective To evaluate the chnical value of two dimensional and color Doppler echocardiography in patients receiving cardiotoxic anthracycline for malignancy. Methods Eighty- three patients during or after intaking anthracycline chemotherapy for malignancy （ATC group） were studied, and 50 age- and gender-matched volunteers without cardiac involvement were served as normal subjects（ control group）. Using a color Doppler ultrasound system（ Philips Sonos - 5500）, Standard echocardiographic measures of cardiac internal diameter and left ventricular function were made. Results No significant difference was found in systolic parameters of left ventricle and the thickening rate of the inter-ventricle septum and posterior wall whereas diastolic parameters were different between ATC group and control group. One or more diastolic variables（the ratio of E and A wave,the deceleration time of E wave and isovolumic relaxation times）were abnormal in 30 patients（36% ） in ATC group. 6 case with a small amount hydropericardium, function parameters of left ventricle, the thickening rate have no relationship with the culmulative dosage of ATC , the amount of time since the first dose , of the inter - ventricle septum and left ventricle posterior wall. Conclusion Two dimensional and color Doppler echocardiography may be valuable to assess the early cardiotoxity of anthracychne.