肺癌化疗患者三维斑点追踪成像参数与化疗药物心脏毒性的相关性

The correlation between three-dimensional speckle tracking imaging parameter and the cardiotoxicity of chemotherapeutics in patients with lung cancer chemotherapy

目的:研究肺癌化疗患者三维斑点追踪成像(3D-STI)参数左室整体面积应变(GAS)与化疗药物心脏毒性的相关性。方法:选择2016年2月～2017年5月期间在西安医学院第二附属医院进行化疗的肺癌患者作为化疗组,选择同期体检的健康者作为对照组,进行3D-STI检查并计算GAS;采集血清并测定心肌毒性标志物、凋亡及氧化应激指标的含量,采集外周血并测定凋亡及氧化应激分子的表达量。结果:化疗组患者的GAS水平以及血清中ALDH2、CAT的含量、外周血中Keap1、Bcl-2的表达强度低于对照组,血清中Copeptin、CK-MB、cTnI、cMyBP-C、sTWEAK、sFas、MDA、8-isoPGF2α的含量以及外周血中Nrf-2、gp91phox、p22phox、Caspase-3的表达强度均显著高于对照组;化疗组患者的GAS水平与血清中Copeptin、CK-MB、cTnI、cMyBP-C、sTWEAK、sFas、MDA、8-isoPGF2α的含量以及外周血中Nrf-2、gp91phox、p22phox、Caspase-3的表达强度呈负相关,与血清中ALDH2、CAT的含量及外周血中Keap1、Bcl-2的表达强度呈正相关。结论:肺癌化疗患者3D-STI参数GAS的变化能够反应氧化应激及凋亡所致心脏毒性的程度。

Objective：To study the correlation between three-dimensional speckle tracking imaging（3 D-STI）parameter global area strain（GAS）and the cardiotoxicity of chemotherapeutics in patients with lung cancer chemotherapy.Methods：Patients with lung cancer who underwent chemotherapy in the Second Affiliated Hospital of Xi＇an Medical University between February 2016 and May 2017 were selected as the chemotherapy group,the healthy subjects who received physical examination during the same period were selected as the control group,the 3 D-STI examination was performed and GAS was calculated;the serum was collected to determine the contents of cardiotoxicity markers as well as apoptosis and oxidative stress indexes,and the peripheral blood was collected to determine the expression of apoptosis and oxidative stress molecules.Results：GAS level,serum ALDH2 and CAT contents as well as peripheral blood Keap1 and Bcl-2 expression intensity of chemotherapy group were lower than those of control group whereas serum Copeptin,CK-MB,cTnI,cMyBP-c,sTWEAK,sFas,MDA and 8-isoPGF2αcontents as well as peripheral blood Nrf-2,gp91 phox,p22 phox and Caspase-3 expression intensity were significantly higher than those of control group;the GAS level in chemotherapy group was negatively correlated with serum Copeptin,CK-MB,cTnI,cMyBP-c,sTWEAK,sFas,MDA and 8-isoPGF2αcontents as well as peripheral blood Nrf-2,gp91 phox,p22 phox and Caspase-3 expression intensity,and positively correlated with serum ALDH2 and CAT contents as well as peripheral blood Keap1 and Bcl-2 expression intensity.Conclusion：The changes of 3 D-STI parameter GAS in patients with lung cancer chemotherapy can reflect the degree of cardiotoxicity induced by oxidative stress and apoptosis.