斑点追踪技术评价乳腺癌化疗前后左心室局部收缩功能

Assessment of left ventricular systolic function in breast cancer before and after chemotherapy using speckle tracking imaging

目的探讨斑点追踪技术（STI）对乳腺癌化疗前后左心室局部收缩功能的评价。方法应用STI检测乳腺癌术后化疗患者左室短轴切面，乳头肌水平的前间壁、后壁的应变曲线，分析并计算左心室局部收缩功能，并与健康对照组进行比较分析。结果①对照组乳头肌水平切面前间壁平均心肌运动速率（MV）、环向应变率（CSR）、径向应变率（RSR）、角速度（AV）、角位移（AE）分别为（2．745±0．330）cm／s、（1．265±0．330）s-1、（1．462±0．460）s-1、（51．224±0．420）°／s和（2．598±0．330）°，化疗组分别为（1．282±0．300）cm／s、（0．271±0．290）S-I、（0．319±0．280）s-1、（25．812±0．290）o／s和（O．339±0．270）°；对照组乳头肌水平切面后壁平均MV、CSR、RSR、AV、AE分别为（2．504±O．240）cm／s、（1．149±0．360）s-1、（1．234±0．210）s-1、（25．998±0．310）°／s和（0．976±0．340）-1，化疗组分别为（1．133±0．280）cm／s、（0．359±0．300）s-1、（0．179±0．220）s-1、（10．915±0．210）。／s和（0．212±0．270）。。与对照组比较，化疗组乳头肌水平切面前间壁、后壁的MV、CSR、RSR、AV、AE均减低，差异具有统计学意义（P〈0．05）。②对照组平均左室射血分数（LVEF）、收缩末期左室内径（LVDd）、收缩末期室间隔厚度（IvsTd）、收缩末期左室后壁厚度（LVPwTd）分别为（65．12±1．45）％、（41．53±2．45）mm、（7．71±0．42）mm和（7．61±0．32）mm，化疗组分别为（63．87±1．03）％、（40．56±2．16）mm、（8．44±0．67）mm和（8．29±0．61）mm，两组比较差异无统计学意义（P〉0．05）。结论斑点追踪技术能够早期、准确地评价乳腺癌化疗前后左室局部收缩功能，为临床早期治疗及预后判断提供有价值的信息。

Objective To evaluate left ventricular systolic function of patients with breast cancer before and after chemotherapy using speckle tracking imaging. Methods Patients with breast cancer after combination chemotherapy regimens line 6 cycles of TAC were selected as Chemotherapy group and healthy persons were selected at random as control group. Chemotherapy group＇s anterior and posterior wall strain curve at short axis view papillary muscle level were acquired by STI. Compared Chemotherapy group and control group with left ventricular regional function. Results （1）The mean of MV, CSR, RSR, AV, AE of short axis view papillary muscle level of anterior wall were （2.745±0.330）cm/s, （1.265±0.330）s-1, （1.462±0.460）s-I, （51.224±0.420）~/s, （2.598±0.330）~ in control group, the mean of MV, CSR, RSR, AV, AE of short axis view papillary muscle level of anterior wall （1.282±0.300）cm/s, （0.271±0.290）s-1, （0.319±0.280）s-1, （25.812±0.290）°/s, （0.339±0.270）° in Chemotherapy group. The mean of MV, CSR, RSR, AV, AE of short axis view papillary muscle level of posterior wall were（2.504±O.240）cm/s, （1.149±0.360）s-1, （1.234±0.210）s-1, （25.998±0.310）°/s, （0.976±0.340）° in control group. The mean of MV, CSR, RSR, AV, AE of short axis view papillary muscle level of posterior wall were （1.133＋0.280）cm/s, （0.359±0.30）s-1, （0.179±0.220）s-1, （10.915±0.210）°/s, （0.212±0.270）°in Chemotherapy group. Significant differences were detected between after Chemotherapy group and control group with decreased MV, CSR, RSR, AV, AE （P〈O.05）. （2）The mean of LVEF, LVDd, IVSTd, LVPWTd were （65.12＋1.45）%, （41.53±2.45）mm, （7.71±0.42）mm, （7.61±0.32）mm in control group, the mean of LVEF, LVDd, IVSTd, LVPWTd were （63.87±1.03）%, （40.56±2.16）mm, （8.44±0.67）mm, （8.29±0.61）mm in Chemotherapy group. There was no significant difference between Chemotherapy group and control group in LVEF, LVDd, IVSTd, LVPWTd （P〉0.05）. Conehtsion Speckle traeking imaging can evaluate regional myocardial function in patients with breast cancer before and after chemotherapy noninvasively and accurately, so that it can provide valuable information for earlier clinical diagnosis and treatment.