3D-HM评估乳腺癌不同化疗周期患者左室收缩功能的价值

The value of 3D-HM in evaluating left ventricular systolic function in breast cancer patients with different chemotherapy cycles

目的:分析三维超声心动图全自动左心定量技术(3D-HM)评估乳腺癌不同化疗周期患者左室收缩功能的价值。方法:选取本院2019年1月至2021年3月收治的61例乳腺癌患者为研究对象,均进行TEC化疗(表柔比星+多西他赛+环磷酰胺),在化疗不同周期(化疗前、化疗第1周期、化疗第3周期、化疗第6周期)予以3D-HM和二维超声心动图(2DE)检查,测量患者左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV),比较不同化疗周期患者左室收缩功能。结果:与化疗前相比,化疗后第1周期及第3周期2D-LVEF均无显著改变(P>0.05),化疗第6周期2D-LVEF显著降低(P<0.05),化疗后2D-LVEDD和2D-LVESD均无显著改变(P>0.05)。与化疗前相比,化疗第1周期3D-LVEF无显著改变(P>0.05),化疗第3周期和第6周期3D-LVEF均显著降低(P<0.05),化疗后3D-LVEDD、3D-LVESD、3D-LVEDV和3D-LVESV均无显著改变(P>0.05)。结论:3D-HM可以早期有效评估乳腺癌化疗患者左心室收缩功能,对指导临床防治患者左心室收缩功能损伤具有重要意义。

Objective:To analyze the value of three-dimensional echocardiography Heart Model(3D-HM)in the evaluation of left ventricular systolic function in patients with breast cancer during different chemotherapy cycles.Methods:61 patients with breast cancer admitted to the hospital between January 2019 and March 2021 were selected as the research subjects,and they were all treated with TEC chemotherapy(epirubicin+docetaxel+cyclophosphamide),and given 3D-HM and two-dimensional echocardiography(2DE)during different cycles of chemotherapy(before chemotherapy,at the first cycle of chemotherapy,the third cycle of chemotherapy and the sixth cycle of chemotherapy).The left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic volume(LVEDV)and left ventricular end-systolic volume(LVESV)were measured among the patients.The left ventricular systolic function was compared among patients with different chemotherapy cycles.Results:Compared with before chemotherapy,there was no significant change in 2D-LVEF at the first cycle and the third cycle of chemotherapy(P>0.05),and 2D-LVEF at the sixth cycle of chemotherapy was significantly reduced(P<0.05),and neither 2D-LVEDD nor 2D-LVESD changed significantly after chemotherapy(P>0.05).There was no significant change in 3D-LVEF at the first cycle of chemotherapy compared to before chemotherapy(P>0.05),and 3D-LVEF at the third and sixth cycles of chemotherapy was significantly decreased(P<0.05).After chemotherapy,there were no significant changes in 3D-LVEDD,3D-LVESD,3D-LVEDV and 3D-LVESV(P>0.05).Conclusion:3D-HM can effectively evaluate the left ventricular systolic function of patients with breast cancer chemotherapy at an early stage,and it is of great significance in guiding the clinical prevention and treatment of patients with left ventricular systolic function injury.