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中国人民解放军总医院老年心血管病研究所
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中华老年多器官疾病杂志编辑委员会
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创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
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曹司琪,陈勇,杨菲,袁静,崔瑞雪.收缩达峰时间离散度评价食管癌患者放疗前后左心室收缩同步性的应用价值[J].中华老年多器官疾病杂志,2020,19(8):571~575
收缩达峰时间离散度评价食管癌患者放疗前后左心室收缩同步性的应用价值
Value of peak strain dispersion for assessment of left ventricular contraction synchronization in patients with esophageal carcinoma before and after radiotherapy
投稿时间:2019-09-11  
DOI:10.11915/j.issn.1671-5403.2020.08.134
中文关键词:  超声心动图;食管癌;左心室功能;应变;达峰时间离散度
英文关键词:echocardiography; esophageal carcinoma; left ventricular function; strain; peak strain dispersion This work was supported by Yangzhou Key R & D
基金项目:扬州市重点研发计划(社会发展) 项目(YZ2016075)
作者单位E-mail
曹司琪 苏北人民医院功能检查科,江苏 扬州225001;大连医科大学研究生院影像医学与核医学系,辽宁 大连 116044 c.y_2008@163.comvalue 
陈勇 苏北人民医院功能检查科,江苏 扬州225001 c.y_2008@163.comvalue 
杨菲 苏北人民医院功能检查科,江苏 扬州225001 c.y_2008@163.comvalue 
袁静 苏北人民医院功能检查科,江苏 扬州225001 c.y_2008@163.comvalue 
崔瑞雪 大连医科大学研究生院影像医学与核医学系,辽宁 大连 116044 c.y_2008@163.comvalue 
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中文摘要:
      目的 探讨收缩达峰时间离散度(PSD)评价食管癌患者放疗前后左心室收缩同步性的应用价值。方法 选取2017年10月至2018年7月在苏北人民医院首次接受胸部放射治疗的食管癌患者60例作为放疗组。同期选取年龄、性别相匹配的健康志愿者25例作为对照组。分别于放疗前、放疗中期(放疗14次后)、放疗结束及放疗结束后1个月采用超声心动图机检查相关参数指标并比较。采用SPSS 25.0软件进行统计分析。变量间相关性采用Spearman相关性分析。结果 与放疗前相比,放疗组患者放疗中期、放疗结束及放疗结束后1个月的常规超声心动图参数差异无统计学意义(P>0.05)。与放疗前相比,放疗组患者放疗中期、放疗结束及放疗结束后1个月的基底段纵向峰值应变达峰时间(TTPLS)[(361.0±29.0)、(376.6±35.1)、(382.7±33.8)和(370.6±36.9)ms]、以及基底段[(92.86±7.39)、(105.67±25.18)、(124.57±31.61)和(110.98±29.93)ms]和中间段[(66.57±23.64)、(87.56±20.13)、(101.57±17.48)和(84.32±23.81)ms]的纵向应变达峰时间最大差值(Tls-dif)均显著延长(P<0.05),与放疗结束时相比,放疗结束后1个月的上述参数有缩短趋势(P<0.05)。与放疗前相比,放疗组患者放疗中期、放疗结束及放疗结束后1个月的PSD均显著增加[(33.20±7.65)、(36.83±8.20)、(40.91±8.36)和(38.53±9.89)ms],而整体纵向峰值应变(GLPS)均显著降低(P<0.05)。与放疗结束时相比,放疗结束后1个月的PSD与GLPS均有向放疗前恢复的趋势(P<0.05)。Spearman相关性分析结果显示,GLPS绝对值与PSD呈显著负相关(r=-0.61,P<0.01)。结论 应用PSD能够评价食管癌患者放疗前后左心室收缩同步性,为临床监测放疗患者心功能,及时调整放疗方案提供帮助。
英文摘要:
      Objective To explore the application value of peak strain dispersion (PSD) for assessment of left ventricular (LV) synchronization in patients with esophageal carcinoma before and after radiotherapy. Methods A total of 60 patients with esophageal carcinoma who received chest radiotherapy for the first time in the Northern Jiangsu People′s Hospital from October 2017 to July 2018 were enrolled in this study. Another 25 age-and sex-matched health volunteers at the same period served as control. Routine echocardiography examinations were performed before, in the middle of (after 14 times of radiotherapy), after and in 1 month after radiotherapy, and the obtained parameters were compared between the two groups. SPSS statistics 25.0 was used to analyze the data. Spearman correlation analysis was employed for correlation analysis. Results There were no significant differences in the echocardiographic parameters before and in the middle, end and in 1 month after radiation (P>0.05). In the above time points, the time to peak longitudinal strain (TTPLS) in basal segment was (361.0±29.0), (376.6±35.1), (382.7±33.8) and (370.6±36.9) ms, respectively, maximum difference of TTPLS (Tls-dif) in basal segment was (92.86±7.39), (105.67±25.18), (124.57±31.61) and (110.98±29.93) ms,respectively, and it in middle segments was (66.57±23.64), (87.56±20.13), (101.57±17.48) and (84.32±23.81) ms. The differences were gradually extended from the middle to the 1 month after radiotherapy (P<0.05). Compared with the end of radiotherapy, the above parameters showed a shortening trend in 1 month after radiotherapy (P<0.05). Compared with the values before radiation,PSD was increased gradually from the middle to the 1 month after radiotherapy [(33.20±7.65) vs (36.83±8.20) vs (40.91±8.36) vs (38.53±9.89) ms], while the absolute value of global longitudinal peak strain (GLPS) was decreased gradually (P<0.05). The PSD and GLPS values gradually recovered to the pre-radiotherapy levels in 1 months after radiation when compared with those at the end of radiotherapy (P<0.05). Spearman correlation analysis indicated that the absolute value of GLPS was negatively correlated with PSD (r=-0.61, P<0.01). Conclusion PSD can be used to evaluate the left ventricular contraction synchronization in esophageal carcinoma patients before and after radiotherapy, and is helpful for monitoring their cardiac function and timely adjusting radiotherapy regimen in clinical practice.
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