超声三维斑点追踪成像评价心复宁Ⅳ号防治乳腺癌患者化疗所致心肌毒性的应用效果

Evaluation of the efficacy of XinfuningⅣin prevention of cardiotoxicity induced by chemotherapy in breast cancer by conventional echocardiography and real-time three-dimensional speck tracking imaging

目的探讨常规超声心动图与实时三维斑点追踪成像技术(RT3D-STI)评价心复宁Ⅳ号防治乳腺癌患者化疗所致心肌毒性的应用效果。方法选取2020年1月至2021年5月广东祈福医院收治并行手术治疗、术后化疗的60例乳腺癌患者作为研究对象,根据治疗方法不同将其分为对照组与研究组,每组各30例。对照组患者采用6周期环磷酰胺加表柔比星化疗方案,研究组患者在对照组的基础上加用心复宁Ⅳ号治疗。所有患者均在化疗前、化疗2、4、6周期后行常规超声心动图与RT3D-STI检查,分析常规超声参数结果、RT3D-STI参数。结果研究组患者化疗6周期后的二尖瓣环舒张早期心肌运动峰值(Em)、二尖瓣舒张早期峰值流速(E)/二尖瓣舒张晚期峰值流速(A)、Em/二尖瓣环舒张晚期心肌运动峰值(Am)高于对照组,差异有统计学意义(P<0.05)。研究组患者化疗2周期后的左心室扭转角度(LVtw)高于对照组,心肌综合指数(MCI)低于对照组;化疗4周期后的LVtw高于对照组,三维应变(3DS)、整体纵向应变(GLS)、MCI低于对照组;化疗6周期后LVtw、3D-LVEF高于对照组,3DS、GLS与MCI低于对照组,差异有统计学意义(P<0.05)。结论通过超声心动图与RT3D-STI监测化疗患者左心室心肌三维应变指标,表明心复宁Ⅳ号能有效防治乳腺癌患者化疗所致的心肌毒性,促进化疗疗程顺利完成。

Objective To evaluate the efficacy of conventional echocardiography and real-time three-dimensional speck tracking imaging(RT3D-STI)in the treatment of chemotherapy-induced cardiotoxicity in breast cancer patients with XinfuningⅣ.Methods A total of 60 breast cancer patients admitted to Guangdong Clifford Hospital from January 2020 to May 2021 who received surgical treatment and postoperative chemotherapy were selected as the research subjects.According to different treatment methods,they were divided into control group and study group,with 30 patients in each group.The control group was treated with 6-cycle Cyclophosphamide plus Epirubicin chemotherapy,and the study group was treated with XinfuningⅣon the basis of the control group.All patients underwent conventional echocardiography and RT3D-STI examination before chemotherapy and after 2,4 and 6 cycles of chemotherapy,and the results of conventional ultrasound parameters and RT3D-STI parameters were analyzed.Results After 6 cycles of chemotherapy,the peak value of early mitral diastolic myocardium movement(Em),peak value of early mitral diastolic myocardium flow rate(E)/peak value of late mitral diastolic myocardium flow rate(A)and peak value of Em/late mitral diastolic myocardium movement(Am)in study group were higher than those in control group,and the differences were statistically significant(P<0.05).After 2 cycles of chemotherapy,the left ventricular torsion angle(LVtw)of patients in the study group was higher than that in the control group,and the myocardial composite index(MCI)was lower than that in the control group.After 4 cycles of chemotherapy,LVtw was higher than that of the control group,while 3D strain(3DS),global longitudinal strain(GLS)and MCI were lower than those of the control group.After 6 cycles of chemotherapy,LVtw and 3D-LVEF were higher than those in the control group,while 3DS,GLS and MCI were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion XinfuningⅣcan reduce the influence of cardiotoxicity caused by chemotherapy,and promote the successful completion of chemotherapy by monitoring the patients′left ventricular myocardial stress parameters uesing RT3D-STI.