發(fā)布時(shí)間：2018-01-28 08:05

  本文關(guān)鍵詞： 乳腺腫瘤 斑點(diǎn)追蹤技術(shù) 蒽環(huán)類藥物 左室功能　出處：《實(shí)用醫(yī)學(xué)雜志》2017年03期 　論文類型：期刊論文

【摘要】：目的:應(yīng)用二維及三維斑點(diǎn)追蹤成像(2D-STE、3D-STE)技術(shù)評(píng)估蒽環(huán)類藥物對(duì)乳腺癌患者左心室功能的毒性作用,比較兩種技術(shù)的臨床應(yīng)用價(jià)值。方法:50例乳腺癌術(shù)后的患者,均采用以表柔比星為主的化療方案,共化療6個(gè)周期。根據(jù)表柔比星累計(jì)劑量達(dá)0、120、240、360 mg/m~2分為不同化療階段(即化療前、化療初期、化療中期、化療后期)。分別于不同化療階段行2D-STE和3D-STE的監(jiān)測(cè)。繪制ROC曲線以評(píng)價(jià)2D-GLS、3D-GLS、3D-GCS及3D-GAS檢測(cè)左室功能早期損害的敏感度及特異度。25例健康女性志愿者組成對(duì)照組。結(jié)果:相比對(duì)照組和化療前,2D-GLS和3D-GCS于化療后期明顯降低(P0.05),3D-GAS、3D-GLS在化療中期及化療后期均明顯減低(P0.05),而3D-GRS在整個(gè)化療階段無(wú)明顯降低。ROC曲線表明2D-GLS、3D-GCS、3D-GLS、3D-GAS判斷蒽環(huán)類藥物對(duì)左室功能損害的敏感度分別為60.7%、65.3%、62.7%、80.7%,特異度分別為50.0%、54.0%、64.0%、82.0%。結(jié)論:與2D-STE比較,3D-STE更具有優(yōu)勢(shì),能夠更早、更準(zhǔn)確的發(fā)現(xiàn)蒽環(huán)類藥物所致的左心室功能損害,且3D-GAS檢測(cè)左心室功能早期損害的敏感度和特異度最高。
[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.
【作者單位】： 安徽醫(yī)科大學(xué)第一附屬醫(yī)院超聲科;
【基金】：安徽省公益性技術(shù)應(yīng)用研究聯(lián)動(dòng)計(jì)劃項(xiàng)目(編號(hào):1501ld04039)
【分類號(hào)】：R737.9;R445.1
【正文快照】： 1501ld04039)蒽環(huán)類藥物(anthracycline)是臨床上常用的化療藥物,然而其產(chǎn)生的不可逆性的心臟毒性作用卻限制了它的使用。二維斑點(diǎn)追蹤成像(two-dimensional speckle tracking echocardiography,2D-STE)技術(shù)利用組成二維超聲圖像的聲學(xué)斑點(diǎn),組織灰階自動(dòng)逐幀追蹤ROI內(nèi)心肌組織

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