您的位置: 首页 > 2021年3月 第52卷 第2期 > 文字全文
2023年7月 第38卷 第7期11
目录

三维斑点追踪技术评价结直肠癌化疗患者左心室功能变化的探究

Evaluation of left ventricular function in patients with colorectal cancer chemotherapy by three-dimensional speckle tracking

来源期刊: 广州医药 | 28-32 发布时间:2021-11-25 收稿时间:2025/11/13 18:11:26 阅读量:33
作者:
关键词:
FOLFOX三维斑点追踪成像技术左心室功能结直肠癌
FOLFOX3D speckle tracking imaging technologyLeft ventricular functionColorectal cancer
DOI:
10.3969/j.issn.1000-8535.2021.02.006
收稿时间:
2020-05-09 
修订日期:
 
接收日期:
 
引用总数:
0  
目的 观察结直肠癌患者使用联合药物FOLFOX化疗前后左心室应变参数的变化。方法 选取健康人30例作为正常组,收集病理确诊为结直肠癌并采用FOLFOX(5-氟尿嘧啶+奥沙利铂+亚叶酸钙)化疗的患者30例,以自身对照做研究,分别在化疗前、化疗1个周期后、化疗6个周期后、化疗12个周期后48 h内完成心脏超声检查,采集左心室的动态图像,获取常规参数:LVEDd、LVEDs、IVSd、LVPWd、LVEDV、LVESV、LVEF、LVFS;三维参数:SPI、SV、CO、LVEDMass、LVESMass、GAS、GRS、GLS、GCS,并比较化疗前后这些数值的变化。结果 正常组与各化疗组相比对,LVEDd、LVEDs、IVSd、LVPWd、LVPW、LVESV、SPI的变化均无统计学意义(P>0.05);LVEF、LVFS、SV、CO在化疗中、后期出现了降低,差异有统计学意义(P<0.05),HR、LVEDMass、LVESMass略升高,差异有统计学意义(P<0.05);化疗后GLS及GAS较化疗前明显减低(P<0.05),其中GAS的ROC曲线下面积为0.883,P<0.001,选30%为诊断界点,灵敏度为86.7%,特异度为80%;GLS的ROC曲线下面积为0.888,P<0.001,选19%为诊断界点,灵敏度为73.3%,特异度为90.0%。结论 三维斑点追踪技术能够早期发现FOLFOX致结直肠癌患者左心室功能的变化,其中LVGLS、LVGAS是有力的观测指标。
Objective To observe the changes of left ventricular strain parameters in patients with colorectal cancer before and after combined chemotherapy with FOLFOX. Methods 30 healthy people were selected as normal group, and 30 patients with pathologically diagnosed colorectal cancer and FOLFOX (5-fluorouracil +oxaliplatin+calcium leucovorin) chemotherapy were collected. Before, after 1 cycle of chemotherapy, after 6 cycles of chemotherapy, and within 48 hours after 12 cycles of chemotherapy, cardiac ultrasound examination was performed, and dynamic images of the left ventricle were collected to obtain conventional parameters: LVEDd, LVEDs, IVSd, LVPWd, LVEDV, LVESV, LVEF, LVFS; three-dimensional parameters: SPI, SV, CO, LVEDMass, LVESMass, GAS, GRS, GLS, GCS, and the changes of these values before and after chemotherapy were compared. Results Compared with the chemotherapy group, the normal group had no statistically significant changes in LVEDd, LVEDs, IVSd, LVPWd, LVPW, LVESV, and SPI (P>0.05); LVEF, LVFS, SV, CO were in the middle and late stages of chemotherapy. There was a decrease, the difference was statistically significant (P<0.05), HR, LVEDMass, LVEESMass were slightly increased, the difference was statistically significant (P<0.05); LGS and GAS after chemotherapy were significantly lower than before chemotherapy (P<0.05), the area under the ROC curve of GAS is 0.883, P=0.000, 30% is selected as the diagnostic boundary, the sensitivity is 86.7%, and the specificity is 80%; the area under the ROC curve of GLS is 0.888, P=0.000, 19% as a diagnostic boundary, the sensitivity is 73.3% and the specificity is 90.0%. Conclusion Three-dimensional speckle tracking technology can detect the changes of left ventricular function in patients with colorectal cancer caused by FOLFOX in early stage, of which LVLGS and LVGAS are powerful observation indicators.
1、 MIYOSHI T, TANAKA H, KANEKO A, et al. Left ventricular endocardial dysfunction in patients with preserved ejection fraction after receiving anthracycline[J]. Echocardiography, 2014,31(7):848-857. MIYOSHI T, TANAKA H, KANEKO A, et al. Left ventricular endocardial dysfunction in patients with preserved ejection fraction after receiving anthracycline[J]. Echocardiography, 2014,31(7):848-857.
2、 KLEIJI S, ALY M. Three-dimensional speckle tracking echocardiography for automatic assessment of global and regional left ventricular function based on area strain[J]. J Am Soc Echocardiogr,2011,24(3):314-321. KLEIJI S, ALY M. Three-dimensional speckle tracking echocardiography for automatic assessment of global and regional left ventricular function based on area strain[J]. J Am Soc Echocardiogr,2011,24(3):314-321.
3、 梁梦婕, 金怡, 郑哲岚. 超声二维斑点追踪技术在蒽环类化疗药物心脏毒性监测中的应用价值[J]. 中华医学超声杂志(电子版), 2019, 16(10):749-755. 梁梦婕, 金怡, 郑哲岚. 超声二维斑点追踪技术在蒽环类化疗药物心脏毒性监测中的应用价值[J]. 中华医学超声杂志(电子版), 2019, 16(10):749-755.
4、 ZHU M, CHEN H. The value of left ventricular strain-volume loops in predicting response to cardiac resynchronization therapy[J]. Cardiovasc Ultrasound,2019,17(1):3. ZHU M, CHEN H. The value of left ventricular strain-volume loops in predicting response to cardiac resynchronization therapy[J]. Cardiovasc Ultrasound,2019,17(1):3.
5、 POLK A, VISTISEN K. A systematic review of the pathophysiology of 5-fluor-ouracil-induced cardiotoxicity[J]. BMC Pharmacol Toxicol,2014,15(1):47. POLK A, VISTISEN K. A systematic review of the pathophysiology of 5-fluor-ouracil-induced cardiotoxicity[J]. BMC Pharmacol Toxicol,2014,15(1):47.
6、 PENG J, DONG C, WANG C, et al. Cardiotoxicity of 5-fluorouracil and capecitabine in Chinese patients: a prospective study[J]. Cancer Commun (Lond), 2018,38(1):22. PENG J, DONG C, WANG C, et al. Cardiotoxicity of 5-fluorouracil and capecitabine in Chinese patients: a prospective study[J]. Cancer Commun (Lond), 2018,38(1):22.
7、 郑晓娟. 氟尿嘧啶类药物相关性心脏毒性的系统综述和Meta分析[D].沈阳:中国医科大学,2018. 郑晓娟. 氟尿嘧啶类药物相关性心脏毒性的系统综述和Meta分析[D].沈阳:中国医科大学,2018.
8、 孙凌宇. 2019版《日本结直肠癌治疗指南》精要及解读[J].中华胃肠外科杂志,2019,22(11): 1088-1094. 孙凌宇. 2019版《日本结直肠癌治疗指南》精要及解读[J].中华胃肠外科杂志,2019,22(11): 1088-1094.
9、 MURARUD,NIERO A. Three-dimensional speckle-tracking echocardiography: benefits and limitations of integrating myocardial mechanics with three-dimensional imaging[J]. Cardiovasc Diagn Ther,2018,8(1):101-117. MURARUD,NIERO A. Three-dimensional speckle-tracking echocardiography: benefits and limitations of integrating myocardial mechanics with three-dimensional imaging[J]. Cardiovasc Diagn Ther,2018,8(1):101-117.
10、 CHONG J H, GHOSH A K. Coronary Artery Vasospasm Induced by 5-fluorouracil: Proposed mechanisms, existing management options and future directions[J]. Interv Cardiol,2019,14(2):89-94. CHONG J H, GHOSH A K. Coronary Artery Vasospasm Induced by 5-fluorouracil: Proposed mechanisms, existing management options and future directions[J]. Interv Cardiol,2019,14(2):89-94.
11、 DYHL A,VAAGE M, SCHOU M,et al. Incidence and risk markers of 5-fluorouracil and capecitabine cardiotoxicity in patients with colorectal cancer[J]. Acta Oncol,2020,59(4):475-483. DYHL A,VAAGE M, SCHOU M,et al. Incidence and risk markers of 5-fluorouracil and capecitabine cardiotoxicity in patients with colorectal cancer[J]. Acta Oncol,2020,59(4):475-483.
12、 JOY G, EISSA H. Fluorouracil-induced Takotsubo cardiomyopathy causing cardiogenic shock: a case report of clinical and acute cardiac magnetic resonance imaging features[J]. Eur Heart J Case Rep,2019,3(4):1-6. JOY G, EISSA H. Fluorouracil-induced Takotsubo cardiomyopathy causing cardiogenic shock: a case report of clinical and acute cardiac magnetic resonance imaging features[J]. Eur Heart J Case Rep,2019,3(4):1-6.
13、 KEUM N N, GIOVANNUCCI E. Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies[J]. Nat Rev Gastroenterol Hepatol,2019,16(12):713-732. KEUM N N, GIOVANNUCCI E. Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies[J]. Nat Rev Gastroenterol Hepatol,2019,16(12):713-732.
上一篇
下一篇
出版者信息








《广州医药》公众号
目录