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Tei指数监测蒽环类药物对肿瘤患者心功能的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2008年第6期
页码:
769-772
栏目:
临床研究
出版日期:
2008-12-25

文章信息/Info

Title:
Tei index in assessment of cardiac function in malignant patients treated with anthracycline
作者:
姜志荣; 张小花; 常洪彷
青岛大学医学院附属医院特检科，山东 青岛 266003
Author(s):
JIANG Zhirong;  ZHANG Xiaohua;  Chang Hongfang
Department of Special Examination, Affiliated Hospital to Medical College, Qingdao University, Qingdao 266003, Shandong, China
关键词:
超声心动描记术; Tei指数; 蒽环类药物; 化学疗法; 心脏功能
Keywords:
echocardiography;  Tei index;  anthracycline;  chemotherapy;  cardiac function
分类号:
R543
DOI:
-
文献标识码:
A
摘要:
目的 探讨心肌做功指数(myocardial performance index，MPI，又称Tei指数)在评价蒽环类药物（anthracycline，ATC）对肿瘤患者心功能早期损害方面的临床应用价值。方法 测定并比较50例肿瘤患者ATC化疗前和化疗后6个月常规超声心动图参数及Tei指数参数。结果 Tei指数各相关参数显示ATC化疗后左、右心室等容舒张时间（IRT、IRT′）较化疗前明显延长（P<0.05）；左、右心室等容收缩时间(ICT、ICT′)，左室及右室射血时间（ET、ET′）较化疗前无显著性差异，但左、右心室Tei指数较化疗前有显著性增加（P<0.05）。左室射血分数（LVEF）在化疗前后无显著性差异,仅14例（28%）患者化疗后出现常规左室舒张功能指标异常，其中4例（8%）同时并发右心室舒张功能指标异常。结论 Tei指数能更早、更敏感地评价ATC对肿瘤患者心脏功能损害。
Abstract:
AIM To explore the clinical value of Tei index in assessing cardiac function damage in malignant patients receiving cardiotoxic anthracycline chemotherapy. METHODS Fifty patients treated with anthracycline chemotherapy were examined by echocardiography and Tei index before and six months after chemotherapy. RESULTS Parameters of Tei index showed that after chemotherapy, left ventricular and right ventricular isovolumic relaxation time (IRT and IRT′) were significantly prolonged (P<0.05), isovolumic systolic time (ICT and ICT′) and ejection time (ET and ET′) were not significantly different, but left ventricular and right ventricular Tei indexes were significantly different (P<0.05). Parameters of conventional echocardiography showed that the parameters of left ventricle systolic function after anthracycline chemotherapy were not significantly different compared with those before chemotherapy. The regression of routine diastolic function index of left ventricle was seen in only 14 patients (28%), only 4 patients (8%) of whom had abnormalities of routine diastolic function index of right ventricle. CONCLUSION Compared with conventional echocardiography, Tei indexes are more sensitive in detecting abnormalities of cardiac function in malignant patients treated with anthracycline.

参考文献/References

［1］ Spencer KT, Weinert L, Avi VM, et al. Automated calculation of the Tei index from signal averaged left ventricular acoustic quantification wave forms［J］. J Am Soc Echocardiogr, 2002, 15(12): 1485-1489.

［2］ Tei C, Ling LH, Hodge DO, et al. New index of combined systolic and diastolic myocardial performance:a simple and reproducible measure of cardiac funtiona study in normals and dilated cardiomyopathy［J］. J Cardiol, 1995, 26(6): 357-366.

［3］ 臧益民，朱妙章，袁丽君，等. 心脏功能无创伤检测的研究进展［J］. 心脏杂志， 2005， 17(3)：292-300.

［4］ Tei C. New noninvasive index for combined systolic and diastolic ventricular function［J］. J Cardiol, 1995, 26(2):135-136.

［5］ Tei C, Nishimura RA, Seward JB, et al. Noninvasive Dopplerderived myocardial performance index: correlation with simultaneous measurements of cardiac catheterization measurement［J］. J Am Soc Echocardiogr, 1997, 10(2):l69-178.

［6］ Ishii M, Tsutsumi T, Himeno W, et al. Sequential evaluation of left ventricular myocardial performance in children after anthracycline therapy［J］. Am J Cardiol, 2000, 86(11):1279-1281.

［7］ Eidem BW, Sapp BG, Suarez CR, et al. Usefulness of the myocardial performance index for early detection of anthracyclineinduced cardiotoxiclty in children［J］. Am J Cardiol, 2001, 87(9):1120-1122,A9.

备注/Memo

备注/Memo:
收稿日期：2007-09-06. 基金项目：山东科技攻关项目（2006GG2302024） 通讯作者：姜志荣，教授，主要从事心血管疾病超声诊断研究 Email:jiangzhirong2@163.com
更新日期/Last Update: 2009-03-24