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目的探讨应用二维斑点追踪技术评价蒽环类药物对于不同心脏基础情况乳腺癌患者的左室旋转及扭转功能影响。方法选取40例乳腺癌患者,分为心脏正常组(A组)、心脏高危组(B组)。每例分为化疗前、化疗2周期后、化疗4周期后、化疗6周期后4个阶段。每个阶段获取左室短轴基底水平及心尖水平的高帧频动态二维图像,运用QLAB软件进行联机分析,获得左室基底段、心尖段内膜旋转、外膜旋转、整体平面旋转、壁扭转曲线,记录各曲线峰值角度,并进行统计学分析。结果化疗2周期后,B组的左室旋转及扭转曲线峰值较前有所增加,部分患者曲线形态不规则,差异有统计学意义(P>0.05)。化疗4周期后,A组各曲线峰值开始出现改变,差异有统计学意义(P<0.05);而此时B组改变更加显著(P<0.01)。结论2D-STE技术可以发现蒽环类药物对乳腺癌患者的早期心脏损害。而且心脏高危组与正常组的心肌损害有显著性不同。对于心脏高危组患者,更应该严格监控其早期心脏损害,从而指导临床及时调整药物使用方案。
Objective To evaluate the effect of anthracycline on left ventricular rotation and torsion in patients with breast cancer under different cardiac conditions by using two-dimensional speckle tracking. Methods Forty cases of breast cancer were selected and divided into normal group (group A) and high risk group (group B). Each case is divided into pre-chemotherapy, chemotherapy 2 cycles, 4 cycles of chemotherapy, 6 cycles of chemotherapy after 4 stages. At each stage, a 2D high dynamic frame rate image of left ventricular basement and apical level was acquired and analyzed by QLAB software. The left ventricular basement segment, apical segment intima-media rotation, adventitia rotation, whole plane rotation, Twist the curve, record the peak angle of each curve, and make statistical analysis. Results After 2 cycles of chemotherapy, the peak value of left ventricular rotation and torsion curve in group B was increased compared with that before. The curve of some patients was irregular with statistical significance (P> 0.05). After 4 cycles of chemotherapy, the peak value of each curve in group A began to change, the difference was statistically significant (P <0.05); at this time, the change in group B was more significant (P <0.01). Conclusion 2D-STE can detect early heart damage of anthracycline in patients with breast cancer. And myocardial damage in high-risk group and normal group were significantly different. For patients with high risk of heart disease, it should be more rigorous monitoring of its early heart damage, thus guiding the clinical timely adjustment of drug use program.