二维斑点追踪技术评价曲妥珠单抗联合蒽环类药物对乳腺癌患者心脏毒性的价值

Evaluation of Trastuzumab Combined with Anthracycline Drugs Using Two-dimensional Dot Tracking Technology The value of Cardiotoxicity in Patients with Breast Cance

目的探讨二维斑点追踪技术早期监测左心室收缩功能评价乳腺癌患者在接受蒽环类药物联合曲妥珠单抗联合治疗后产生心脏毒性的价值。方法乳腺癌术后患者50例,均接受蒽环类药物联合曲妥珠单抗联合治疗,分别于治疗前、治疗中期及治疗后期常规进行心电图、二维超声心动图及二维斑点追踪技术监测,主要观察指标为左心室射血分数(LVEF)及整体纵向应变(GLS),30例健康志愿者作为对照组。结果①GLS在化疗中期及后期时较对照组、化疗前均明显减低(P<0.05)。②LVEF在化疗中期及后期对比化疗前或对照组差异均无显著意义。结论应用二维斑点追踪技术测得的整体纵向应变值(GLS)能评价乳腺癌患者治疗后药物所致的左心室功能障碍的微小变化,尽早发现心肌功能的损害。

Objective To explore the value of two-dimensional dot tracking technique in early monitoring left ventricular systolic function in evaluating the cardiac toxicity of patients with breast cancer after treatment with trastuzumab combined with anthracycline drugs.Methods 50 cases of postoperative breast cance,All patients were treated with trastuzumab combined with anthracycline drugs.Routine monitoring of electrocardiogram,two-dimensional echocardiography,and two-dimensional spot tracking technology before,during,and after treatment.The main outcome measures were left ventricular ejection fraction(LVEF)and overall longitudinal strain(GLS).30 healthy volunteers served as the control group.Results(1)GLS significantly decreased in the middle and late stages of chemotherapy compared to the control group and before chemotherapy(P<0.05);(2L)There was no significant difference in LVEF between the pre chemotherapy group and the control group in the middle and late stages of chemotherapy.Conclusions The global longitudinal strain value(GLS)measured by two-dimensional spot tracking technology can evaluate the small changes of drug induced left ventricular dysfunction in breast cancer patients after treatment,and detect the damage of myocardial function as soon as possible。