纵向应变参数评估乳腺癌蒽环类药物化疗相关早期心肌损伤及红黄煎剂干预效果的临床研究

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Aclinical studyoflongitudinalstraininevaluatingearlyanthracycline-relatedcardiactoxicityinbreastcancerpatients and the efficacy of Honghuang Decoction

ZHU Menglin'， LU Meijuan'，XUE Jingxian²

1DepartmentofFunctional Examination，Jiangsu Provincial HospitalofChineseMedicine，Nanjingloo29，China; 2 Departmentof BreastSurgery，Jiangsu Provincial Hospital ofChinese Medicine，Nanjing21oo29，China.

[Abstract]Objective：Usingleftventriclelongitudinalstrain（LS）parametersderivedfromspeckletrackingimaging toearly identifyanthracycline-relatedmyocadialtoxicityinbreastcancerpatients.Aditionalythisstudyaimstoevaluatethecliical valueofearlyinterventionusing Honghuang Decoction.Methods：Atotalof38femaleswithbreastcancerwereenroled. Theyweredividedintoacontrolgroup（16cases）andanexperimentalgroup（22cases）．Bothgroupsreceivedconventional anthracyclinechemotherapyfor4-8cycles，andtheexperimentalgroupalsoreceivedHonghuang Decoctionfromthefirstday ofeachchemotherapycycleuntiltheseventhdayafterthischemotherapy.Transthoracicechocardiographywasperformed beforechemotherapy，3and6monthsafterchemotherapytoobtainconventionalexaminationparameters（LAD，LVEDd，mitral annular septum s'，lateral wall s’，SV，LVEF） as well as LS parameters （LSendo，LSmid，LSepi） ．All the parameters were compared between the two groups. Results：The absolute values of left ventricular LSendo，LSmid，LSepi exhibiteda pattern of initial decrease follwedbyanincreasebeforechemotherapy，3and6monthsafterchemotherapy，andtheseparametersessntiallretumed to pre-chemotherapy levels at 6 months after chemotherapy（all P>0.05 ）．In the control group，LSendo，LSmid，LSepi showed a continuousdecreasingtrend，withsignificantlylowervaluesat6monthsafterchemotherapycomparedtopre-chemotherapy（al （2 P<0.05 ）.LAD，LVEDd，septals’，lateral s’，SVandLVEFof the twogroups hadnosignificantdiferencesat6 months after chemotherapy compared to before chemotherapy（all P>0.05 ）.Conclusions：The left ventricle LS is more sensitive than traditionalechocardiographicparametersinearlydetectionofmyocardialdamagecausedbyanthracyclines.Oraladministration of Honghuang Decoction during chemotherapy can improve early anthracycline-related myocardial toxicity.

[Key words] Longitudinal strain;Breast cancer;Anthracycline;Honghuang Decoction;Ultrasonography

乳腺癌发病率在我国女性恶性肿瘤中居第2位，死亡率居第5位[]。（剩余7763字）