| 洪少杰,林树洪,于瑞芳.超声二维斑点追踪技术监测蒽环类药物治疗恶性淋巴瘤后心脏功能变化[J].肿瘤学杂志,2017,23(1):49-53. |
| 超声二维斑点追踪技术监测蒽环类药物治疗恶性淋巴瘤后心脏功能变化 |
| Cardiac Function Monitoring by Two-dimensional Speckle Tracking Imaging in Lymphoma Patients with Anthracyclines Chemotherapy |
| 投稿时间：2016-08-18 |
| DOI：10.11735/j.issn.1671-170X.2017.01.B010 |
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| 中文关键词: 蒽环类药物 非霍奇金淋巴瘤 心脏毒性 超声二维斑点追踪成像技术 |
| 英文关键词:anthracyclines non-Hodgkin’s lymphoma cardiotoxicity two-dimensional speckle tracking imaging |
| 基金项目:汕头市重点科技项目（汕市财教［2013］244号-71） |
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| 中文摘要: |
| 摘 要：［目的］ 探讨超声二维斑点追踪成像（2D-STI）技术在监测恶性淋巴瘤蒽环类药物（ANTH）化疗后心脏功能变化及评价ANTH亚临床期心脏毒性方面的价值。［方法］ 选择初发确诊非霍奇金淋巴瘤（NHL）住院患者42例。所有患者均具有化学治疗指征，采用标准CHOP方案化疗。应用2D-STI技术，于化疗前、化疗第2、4、6个疗程后，即阿霉素累积剂量为100mg/m2、200mg/m2、300mg/m2后，采集心脏整体纵向应变（GLS）、整体径向应变（GRS）、整体圆周应变（GCS）及左室扭转角度（LVtw）参数，进行化疗前后不同疗程比较；同时也对患者治疗前及治疗后不同疗程常规超声心动图的左室射血分数（LVEF）、E峰与A峰的比值（E/A）、E/e’和心肌做功指数（Tei指数）的变化进行对比分析。［结果］ GLS在化疗第2疗程后、第4疗程后和第6疗程后均较化疗前明显降低（分别为P=0.002，P<0.001，P<0.001）。而GRS、GCS在第6疗程后出现明显下降（分别为P<0.001、P=0.008）。化疗第4疗程、第6疗程后，LVtw比化疗前明显降低（P值均<0.001）。Pearson相关分析显示GLS、LVtw与阿霉素的累积剂量呈负相关。常规超声心动图LVEF、E/A、E/e’和Tei指数在化疗前后不同疗程改变不明显。［结论］ 2D-STI技术可以早期发现NHL患者ANTH化疗后心脏功能变化，可用于监测NHL患者ANTH化疗后亚临床期心脏功能减退。GLS和LVtw可以作为评价ANTH亚临床心脏功能减退的敏感参数。GLS和LVtw的减低与ANTH累积剂量呈负相关。 |
| 英文摘要: |
| Abstract：［Objective］ To monitor the cardiac function by two-dimensional speckle tracking imaging(2D-STI) in malignant lymphoma patients receiving anthracyclines(ANTH) chemotherapy. ［Methods］ Forty-two patients with newly diagnosed non-Hodgkin’s lymphoma(NHL) received standard CHOP regimen. 2D-STI and conventional echocardiography were performed before chemotherapy，and after 2，4，6 chemotherapy cycles，when the cumulative doses of adriamycin was 100mg/m2，200mg/m2 and 300mg/m2. Global longitudinal strain(GLS)，global radial strain(GRS)，global circumferential strain(GCS)，left ventricular torsion angle(LVtw)，along with conventional indicators of myocardial function including left ventricular ejection fraction(LVEF)，E/A，E/e′ and Tei index were assessed and compared between pre- and post-chemotherapy. ［Results］ Compared with pre-chemotherapy，GLS was significantly reduced after 2，4 and 6 chemotherapy cycles(P=0.002，P<0.001 and P<0.001，respectively). A significant reduction in GRS and GCS were observed between pre-chemotherapy and after 6 chemotherapy cycles(P<0.001，P=0.008，respectively). LVtw was significantly reduced after 4 and 6 chemotherapy cycles as compared with that before chemotherapy(both P<0.001). Pearson correlation analysis revealed that GLS and LVtw were negatively correlated with the cumulative dose of ANTH. No significant change was observed in LVEF，E/A，E/e′ and Tei index before and after chemotherapy. ［Conclusion］ 2D-STI technology can detect subclinical cardiac dysfunction and monitor mild changes of cardiac function in NHL patients receiving ANTH chemotherapy. GLS and LVtw can be used as sensitive indicators for evaluation of subclinical cardiac dysfunction after ANTH chemotherapy，which are negatively correlated with the cumulative dose of ANTH. |
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