采用回声跟踪技术研究乳腺癌患者联合化疗对颈总动脉僵硬度及脉搏波参数的影响

A. Zairova, A. Rogoza, A. Avalyan, E. Oshchepkova
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引用次数: 0

摘要

本研究的目的是研究联合化疗对女性乳腺癌(BC)动脉硬度和脉冲波的影响,超声检查颈总动脉(CCA)采用回声跟踪技术。材料和方法。40例27 ~ 75岁(47.5±12.0)三阴性乳腺癌患者接受蒽环类药物(阿霉素)、紫杉醇类药物(紫杉醇)和铂衍生物(顺铂)化疗后及化疗初期检查。采用回声跟踪技术,在Aloka ProSound α7超声机上研究了距离分叉2 cm远端CCA动脉刚度参数(β-刚度指数、ep -弹性模量、ac -动脉顺应性、pwv脉搏波速)和AI增强指数。联合化疗后b、Ep、PWV参数无明显变化(9,3±4,3 vs 8,9±4,5,r =0,63;128,73±65,9 vs 119,0±69,5 кПа, r =0,29;6,7±1,5 vs 6,3±1,5 m/s,分别为0,24)。AI从14.5±11.3下降到11.1±10.6% (p=0.009), AC从0.72±0.25上升到0.87±0.3 mm2 / kPa (p=0.004),收缩压(SBP)从129.5±14.0下降到118.5±14.5 mmhg (p=0.0001),心率从67.9±10.7上升到76.6±12.1 bpm (p=0.0004),血红蛋白从129.6±20.4下降到102.2±16.3 g / l (p=0.00001),红细胞从4.7±0.4下降到3.3±0.6 1012 / l (p=0.00001)。结论:早期乳腺癌妇女在蒽环类药物(阿霉素)、紫杉醇(紫杉醇)和铂衍生物(顺铂)联合化疗后,颈总动脉僵硬度未增加。假性阳性变化表现为血管壁伸展性增加和增强指数降低,这可以用一般血流动力学变化来解释,表现为收缩压降低、心率增加以及化疗期间贫血。
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THE EFFECT OF COMBINED CHEMOTHERAPY IN WOMEN WITH BREAST CANCER ON THE STIFFNESS OF THE COMMON CAROTID ARTERY AND PULSE WAVE PARAMETERS STUDIED BY ECHO TRACKING
The aim of the study was to study the effect of combined chemotherapy in women with breast cancer (BC) on arterial stiffness and pulse wave by ultrasound examination of the common carotid artery (CCA) using echo tracking technology.Materials and methods. 40 women with triple negative breast cancer aged 27 to 75 years (47.5±12.0) were examined initially and after chemotherapy with the inclusion of anthracyclines (doxorubicin), taxanes (paclitaxel) and platinum derivatives (cisplatin). Arterial stiffness parametres (β-stiffness index, Ep-elastic modulus, AC-arterial compliance, PWV-pulse wave velocity) and AI - augmentation index were studied in the distal CCA at a distance of 2 cm from bifurcation on an Aloka ProSound α7 ultrasound machine using echo tracking technology.Results. After combined chemotherapy the parameters b, Ep, PWV not significantly changed (9,3±4,3 vs 8,9±4,5, р=0,63 ;128,73±65,9 vs 119,0±69,5 кПа, р=0,29 ; 6,7±1,5 vs 6,3±1,5 m/s, р=0,24 respectively). Statistically significant decrease in AI from 14, 5±11.3 to 11.1±10.6% (p=0.009) and an increase in AC from 0.72±0.25 to 0.87±0.3 mm2 / kPa (p=0.004) were demonstrated as well as decrease in systolic blood pressure (SBP) from 129.5±14.0 to 118.5±14.5 mm Hg (p=0.0001) and an increase in heart rate from 67.9±10.7 to 76.6±12.1 bpm (p=0.0004), lower the level of hemoglobin from 129.6±20.4 to 102.2±16.3 g / l (p=0.00001) and red blood cells from 4.7±0.4 to 3.3±0.6 1012 / l (p=0.00001).Conclusion: In women with breast cancer in the early period after combined chemotherapy with the inclusion of anthracyclines (doxorubicin), taxanes (paclitaxel) and platinum derivatives (cisplatin), there were no increased stiffness of the common carotid artery. Pseudo-positive changes in the form of an increase in the extensibility of the vascular wall and a decrease in the augmentation index are explained by general hemodynamic changes in the form of a decrease in the SBP, an increase in heart rate, as well as anemia during chemotherapy.
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