GDF-15及三维斑点追踪技术对应用蒽环类药物的乳腺癌患者出现早期心脏毒性的预测价值

Prediction Value of GDF-15 and 3D-STI Technology in the Early Cardiac Toxicity of Breast Cancer Patients with Anthracycline Therap

目的探讨GDF-15及三维斑点追踪技术对应用蒽环类药物的乳腺癌患者出现早期心脏毒性的预测价值。方法收集乳腺癌患者60例,均接受EC/AC-D联合化疗方案。分别于化疗前、化疗2周期、化疗4周期后对患者进行超声及血液检查。结果与化疗前超声心动图指标相比,化疗2周期及4周期后患者左室ESV、EDV、LVEF、E/A及SV均无明显差异(P>0.05)。与化疗前应变参数相比,化疗2周期及4周期后患者GLS及GAS均下降(P<0.05),而GCS、GRS变化不明显(P>0.05)。与化疗前相比,化疗2、4周期后患者血液相关指标均显著升高(P<0.05)。多因素Logistic回归分析表明仅有GDF-15、cTnl及GLS为乳腺癌患者行蒽环类药物治疗出现心脏毒性的独立预测因素(P<0.05)。结论GDF-15及三维斑点追踪技术在评估蒽环类药物对乳腺癌患者心脏毒性的预测方面有较高的应用价值,可作为早期监测其心脏毒性的可靠方法。

Objective To investigate the prediction value of GDF-15 and 3D-STI technology in the early cardiac toxicity of breast cancer patients with anthracycline therapy.Methods 60 breast cancer patients were collected and received EC/AC-D combination chemotherapy regimen.Ultrasound parameters and blood parameters were measured before,at 2 weeks and after 4 weeks of chemotherapy.Results There were no significant differences in LV ESV,EDV,LVEF,E/A and SV after 2 and 4 cycles of chemotherapy compared with the pre-chemotherapy echocardiographic parameters(P>0.05).Compared with pre-chemotherapy strain parameters,GLS and GAS decreased after 2 and 4 cycles of chemotherapy(P<0.05),while GCS and GRS did not change significantly(P>0.05).The blood-related indexes were significantly higher in patients after 2 and 4 cycles of chemotherapy compared with those before chemotherapy(P<0.05).Multifactorial Logistic regression analysis showed that only GDF-15,cTnl and GLS were all independent predictors of cardiotoxicity in breast cancer patients treated with anthracyclines(P<0.05).Conclusion GDF-15 and 3D speckle tracking techniques have high application in assessing the prediction of cardiotoxicity of anthracyclines in breast cancer patients and can be a reliable method for early monitoring of their cardiotoxicity.