超声斑点追踪评价蒽环类药物对左心室扭转运动的影响

目的：应用斑点追踪技术定量评价蒽环类化疗药物对乳腺癌患者左心室旋转及扭转功能的影响。方法选取经术后病理证实为乳腺癌且接受以蒽环类药物为主化疗方案的患者30例，依据蒽环类药物在体内累积量的不同分为A（化疗前）、B（120～340 mg／m^2）、C（360 mg／m^2）三组，对三组患者分别进行超声心动图常规测量及存储左心室基底部及心尖部水平短轴切面动态二维图，应用斑点追踪技术分析左心室基底部及心尖部水平短轴切面各节段的旋转角度值及扭转角度值，比较随着蒽环类药物体内累积量的增加时常规超声心动图测量及左心室旋转扭转参数的改变。结果与A组比较，B组左心室基底部及心尖部各节段旋转角度呈减低趋势，差异无统计学意义（P＞0．05）；左心室整体扭转角度明显减低（P＜0．05）。与A组比较，C组左心室基底部前间隔、前壁及心尖部前间隔、前壁、侧壁、后壁、后间隔旋转角度明显减低（ P＜0．05）；左心室基底部、心尖部总体旋转角度及左心室扭转角度明显减低（P＜0．05）。与B组比较，C组左心室心尖部前间隔、前壁、侧壁、后壁及后间隔旋转角度明显减低（P＜0.05）；左心室基底部及心尖部总旋转角度及左心室体扭转角度明显减低（ P＜0．05）。结论斑点追踪技术能在早期更准确反应心肌组织病理学变化所致局部心肌旋转及扭转的异常变化。

Evaluation of Ultrasound Speckle Tracking Anthracycline-based Drugs Effects on Left Ventricular Torsion Movement

Objective To evaluate quantitatively the effects of anthracycline-based chemothera-py drugs on breast cancer patients with left ventricular rotation and the torsion function with spot tracking technology.Methods Select 30 people by postoperative pathologic results con-firmed as breast cancer and willing to accept anthracycline-based drugs with chemotherapy regimens.Then the 3o people were divided into Group A （before treatment）,Group B （120-340 mg/m^2 ） , Group C （ 360 mg/m^2 ） according to the accumulation of anthracycline-based drugs in the body.Separately echocardiography was adopted in routine measurement of patients in three groups and storage of the left ventricle base and apex short axis planedynamic two-di-mensional figure.Speckle tracking technology is used to analyze left ventricular base and apex level short axis twist angle of eachsection and cross section torsion angle.With the increment of anthracycline-based drugs accumulated in the body,observe whether conventional echocar-diographic measurement and left ventricular rotation reverse parameter change is statistically significant.Results Group B compared with group A：The left ventricular segmental base and a-pex of the rotation angle showed a trend of decrease, there was no statistically significant difference （ P〉0.05）;The left ventricular segmental base and apex of the rotation angle showed a trend of decrease,there was no statistically significant difference （ P〈0.05）;Group C com-pared with group A：The left ventricular segmental base and apex of the rotation angle showed a trend of decrease, there was no statistically significant difference （ P〈0.05）;Left ventricular base,apex department general rotation angle and left ventricular torsion angle significantly re-duced （ P〈0.05） .Group C compared with group B：Left ventricular apex department before the interval,anterior wall, lateral wall and back wall and significantly reduced the angle of rotation after the interval （ P〈0.05）;Left ventricular base a