应变率成像监测肿瘤患者蒽环类药物化疗后心脏毒性的研究

Evaluation of cardiac toxicity in patients with tumor treated with anthracycline chemotherapy by strain rate imaging

目的探讨应变率成像早期检测和评估蒽环类药物(ATC)对肿瘤患者心脏毒性的临床价值。方法比较52例恶性肿瘤患者ATC化疗前和化疗后3～6个月的常规超声心动图心肌缩短率(FS)、射血分数(EF)舒张早期最大流速和收缩期最大流速的比值(E/A)指标以及心肌基底段和中间段前间隔、左室后壁、后间隔和左室侧壁中间段和基底段8个位点的收缩期最大应变率(SRs)、舒张早期最大应变率(SRe)。结果与化疗前比较,化疗后所取8个位点的SRs、SRe降低,E/A降低,差异均有统计学意义(P<0.05),化疗前后FS、EF差异无统计学意义(P>0.05)。结论在早期评价ATC对肿瘤患者心脏功能损害方面,SRs、SRe是较敏感的指标,E/A也有一定参考意义。

Objective To explore the clinical value of strain rate imaging （SRI） in early evaluating cardiac toxicity in patients with tumor treated with anthracycline chemotherapy. Methods Fifly - two patients with malignant tumor treated with anthracycline chemotherapy were examined by echocardiography. FS, EF, E/A were obtained, and systolic strain rate（SRs） ,early diastolic strain rate （SRe） of eight positions in mid and basal segment including anterior septum, posterior wall, septum wall, bilateral wall were obtained as well. These echocardiographic parameters before chemotherapy were compared with those three six months after chemotherapy. Results Compared before chemotherapy, the SRs,SRe of eight positions after chemotherapy were decreased,E/A was decreased （P 〈 0. 05） , there was no significant difference of FS, EF compared before chemotherapy （P 〉0.05）. Conclusion SRs, SRe are sensitive indicators in early assessing the damage of cardiac function in patients with tumor,E/A also has certain reference value.