不同模式超声心动图对乳腺癌化疗患者左心室收缩功能的早期诊断价值

目的：评价单心动周期实时全容积三维超声心动图、M型超声心动图及二维双平面Simpson法对乳腺癌化疗患者不同化疗周期左心室收缩功能动态监测的价值。方法：搜集于我院规范化疗女性乳腺癌患者39例，用单心动周期实时全容积三维超声心动图、M型超声心动图以及二维双平面Simpson法测量患者术前及不同化疗周期（6个化疗周期）左室舒张末容积、左室收缩末容积和左室射血分数，分析比较不同化疗周期左心室收缩功能指标的变化。结果： 1、随着化疗药物累积剂量的不断增加，第6化疗周期开始M型超声心动图结果显示左心室射血分数开始下降(61.59±2.12%)，与术前比较（68.40±2.07%)，差异具有统计学意义(P<0.05)；第6化疗周期开始二维双平面Simpson法结果显示左心室射血分数开始下降（59.94±2.98%)，与术前比较（66.71±2.03%)(P<0.05)，差异具有统计学意义；第5化疗周期开始单心动周期实时全容积三维超声心动图结果显示左心室射血分数开始下降（56.87±2.18%)，与术前比较（64.54±1.92%)，差异具有统计学意义(P<0.05)。 2、随着化疗药物累积剂量的不断增加，二维双平面Simpson法、单心动周期实时全容积三维超声心动图结果显示不同化疗周期左室舒张末容积与术前比较，差异均无统计学意义(P>0.05)。 结论：乳腺癌患者随着化疗药物累积剂量的不断增加，会出现左心室收缩功能减低，单心动周期实时全容积三维超声心动图能较M型超声心动图及二维双平面Simpson法更早发现左心室收缩功能指标射血分数减低，能更早发现亚临床左心室收缩功能不全，应于第5化疗周期开始对心脏功能进行重点监测，以便及早发现亚临床左心室收缩功能不全。

Value of different types of echocardiography in early diagnosis of left ventricular systolic function in breast cancer patients who undergoing chemotherapy

Objective:To evaluation the single cardiac cycle in real-time full volume three-dimensional echocardiography,M-mode echocardiography and two-dimensional echocardiography to chemotherapy in breast cancer patients with different chemotherapy cycle left ventricular systolic function of the value of dynamic monitoring.Methods:In order to compare and analysis the changes of left ventricular systolic function in different chemotherapy cycles,this experiment measured the left ventricular end diastolic volume,systolic volume and ejection fraction of patient before surgery and each chemotherapy cycle(six cycles of chemotherapy)with single-beat real-time three-dimensional echocardiography,M-mode echocardiography and two-dimensional biplane Simpson methods through collecting 39 cases of female breast cancer patients treated with chemotherapy in our hospital.Results:1.With the continuous increase of the cumulative dose of chemotherapy drugs,the results of the M type echocardiography of the sixth chemotherapy cycle showed that left ventricular ejection fraction was beginning to decrease(61.59±2.12%), compared with the preoperative phase (68.40±2.07%),the difference was statistically significant (P<0.05).From the beginning of the sixth chemotherapy cycle, the two-dimensional Simpson method reflected that the left ventricular ejection fraction began to decrease(59.94±2.98%),compared with the preoperative phase (66.71±2.03%)(P< 0.05),the difference is statistically significant.From the beginning of the fifth chemotherapy cycle,single-beat real-time three-dimensional echocardiography results demonstrated that left ventricular ejection fraction began to decline (56.87±2.18%),compared with the preoperative phase (64.54±1.92%),the difference was statistically significant (P<0.05).2.With the increase of the cumulative dose of chemotherapy drugs,the two-dimensional Simpson method,single-beat real-time three-dimensional echocardiography results show that,compared with the preoperative phase,the difference of left ventricule end-diastolic volume between different chemotherapy cycles were not statistically significant (P>0.05).Conclusion:With the increasing dose of chemotherapy drugs,the left ventricular systolic function of patients with breast cancer was decreased.Compared with the M-mode echocardiography and two-dimensional biplane Simpson method,single-beat real-time three-dimensional echocardiography emerged its advantage.Not only can it find earlier left ventricular systolic function index reduced ejection fraction,but also it can find the subclinical left ventricular systolic dysfunction earlier.the patient who sicken breast cancer need begin to focus on monitoring cardiac function start at the fifth cycle of chemotherapy