二维和三维斑点追踪技术评价蒽环类药物对乳腺癌患者心脏毒性的对比研究

发布时间：2018-01-28 08:05

本文关键词： 乳腺肿瘤斑点追踪技术蒽环类药物左室功能　出处：《实用医学杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的:应用二维及三维斑点追踪成像(2D-STE、3D-STE)技术评估蒽环类药物对乳腺癌患者左心室功能的毒性作用,比较两种技术的临床应用价值。方法:50例乳腺癌术后的患者,均采用以表柔比星为主的化疗方案,共化疗6个周期。根据表柔比星累计剂量达0、120、240、360 mg/m~2分为不同化疗阶段(即化疗前、化疗初期、化疗中期、化疗后期)。分别于不同化疗阶段行2D-STE和3D-STE的监测。绘制ROC曲线以评价2D-GLS、3D-GLS、3D-GCS及3D-GAS检测左室功能早期损害的敏感度及特异度。25例健康女性志愿者组成对照组。结果:相比对照组和化疗前,2D-GLS和3D-GCS于化疗后期明显降低(P0.05),3D-GAS、3D-GLS在化疗中期及化疗后期均明显减低(P0.05),而3D-GRS在整个化疗阶段无明显降低。ROC曲线表明2D-GLS、3D-GCS、3D-GLS、3D-GAS判断蒽环类药物对左室功能损害的敏感度分别为60.7%、65.3%、62.7%、80.7%,特异度分别为50.0%、54.0%、64.0%、82.0%。结论:与2D-STE比较,3D-STE更具有优势,能够更早、更准确的发现蒽环类药物所致的左心室功能损害,且3D-GAS检测左心室功能早期损害的敏感度和特异度最高。
[Abstract]:Objective: to evaluate the toxic effects of anthracyclines on left ventricular function in breast cancer patients by using 2D and 3D speckle tracing imaging (2D STE3D-STE) technique. Methods 50 patients with breast cancer after operation were treated with epirubicin for 6 cycles. The cumulative dose of epirubicin was 0,120. 240,360 mg/m~2 was divided into different stages of chemotherapy (i.e., before chemotherapy, at the beginning of chemotherapy, and at the middle stage of chemotherapy). The monitoring of 2D-STE and 3D-STE were performed at different stages of chemotherapy. ROC curves were drawn to evaluate 2D-GLSN 3D-GLS. Sensitivity and specificity of 3D-GCS and 3D-GAS in detecting early damage of left Ventricular function. 25 healthy female volunteers were included as control group. Results: compared with control group and before chemotherapy. 2D-GLS and 3D-GCS decreased significantly in the late stage of chemotherapy. However, 3D-GRS had no significant decrease in the whole chemotherapy stage. The ROC curve showed that 2D-GLSN 3D-GCSN 3D-GLS. The sensitivity of 3D-GAS to the diagnosis of left ventricular dysfunction was 60.7 and 65.3, and the specificity was 50.0% and 54.0%, respectively. Conclusion: compared with 2D-STE, 3D-STE is superior to 2D-STE in finding left ventricular function damage caused by anthracycline earlier and more accurately. The sensitivity and specificity of 3 D-gas in detecting early damage of left ventricular function were the highest.
【作者单位】：安徽医科大学第一附属医院超声科;
【基金】：安徽省公益性技术应用研究联动计划项目(编号:1501ld04039)
【分类号】：R737.9;R445.1
【正文快照】： 1501ld04039)蒽环类药物(anthracycline)是临床上常用的化疗药物,然而其产生的不可逆性的心脏毒性作用却限制了它的使用。二维斑点追踪成像(two-dimensional speckle tracking echocardiography,2D-STE)技术利用组成二维超声图像的声学斑点,组织灰阶自动逐帧追踪ROI内心肌组织

【相似文献】