各位作者、审稿专家:
本刊官方微信服务号新增稿件状态查询服务,无需反复登录投稿系统,微信即可随时查看审稿进度、修回通知、录用结果,稿件更新实时推送提醒,同步接收期刊征稿、学术资讯。
微信搜索关注广州医药杂志服务号 → 点击菜单栏「绑定账号」→ 输入投稿邮箱完成账号关联;请关闭微信消息免打扰,避免遗漏稿件通知。
《广州医药》编辑部
目的 探讨多模态深度学习融合心脏超声与心电图特征对冠心病患者心源性猝死的预测价值。方法 选取2024年1月—2025年6月收治的60例冠心病患者,所有患者均接受心脏超声、心电图检查及多模态深度学习模型预测,随访6个月记录心源性猝死事件。根据随访结果分为事件组(n=15)和非事件组(n=45),比较两组临床资料及各项指标差异。结果 多模态深度学习模型预测敏感度为86.67%,特异度为91.11%,准确率为90.00%,AUC为0.923,显著优于单独心脏超声(AUC=0.761)和单独心电图(AUC=0.788)。结论 多模态深度学习融合心脏超声与心电图特征能够有效预测冠心病患者心源性猝死风险,预测性能优于传统单一模态评估方法。
Objective To investigate the predictive value of multimodal deep learning integrating echocardiography and electrocardiogram features for sudden cardiac death in patients with coronary heart disease.Methods A total of 60 patients with coronary heart disease admitted from January 2024 to June 2025 were enrolled.All patients underwent echocardiography,electrocardiogram examination,and multimodal deep learning model prediction,with a 6-month follow-up to record sudden cardiac death events.According to the follow-up results,patients were divided into the event group(n=15) and non-event group(n=45),and clinical data and various indicators were compared between the two groups.Results The multimodal deep learning model achieved a sensitivity of 86.67%,specificity of 91.11%,accuracy of 90.00%,and AUC of 0.923,which were significantly superior to echocardiography alone(AUC=0.761) and electrocardiogram alone(AUC=0.788).Conclusions Multimodal deep learning integrating echocardiography and electrocardiogram features can effectively predict the risk of sudden cardiac death in patients with coronary heart disease,with predictive performance superior to traditional single-modality assessment methods.
目的 观察超声引导下针刺蝶腭神经节治疗过敏性鼻炎的临床疗效。方法 将80例过敏性鼻炎患者随机分成干预组(40例)和对照组(40例),干预组采用超声引导针刺蝶腭神经节,对照组采用常规方法针刺蝶腭穴,每周2次,持续4周。结果 治疗4周后,干预组和对照组均显示出良好疗效。干预组的总有效率为92.50%,对照组的总有效率为82.50%,差异有统计学意义(P<0.05);干预组在鼻症状总分(TNSS)、非鼻症状总分(TNNSS)、视觉模拟量表(VAS)和鼻结膜炎生活质量问卷(RQLQ)等指标上的改善均优于对照组(P<0.05)。结论 超声引导下针刺蝶腭神经节治疗过敏性鼻炎能有效改善患者的临床症状。
Objective To investigate the main clinical effect of acupuncture of pterygopalatine ganglion on patients with allergic rhinitis under the guidance of ultrasound.Methods A total of 80 patients with allergic rhinitis were randomly divided into intervention group and control group.The intervention group was treated with ultrasound guided acupuncture of the sphenopalatineganglion,the control group was treated with conventional acupuncture at sphenopalatine point.The clinical efficacy was determined after the course of treatment.Results The total effective rate was 92.50% in the intervention group and 82.50% in the control group.The improvement of total nasal symptom score,total non-nasal symptom score,VAS and Arhinoconjunctivitis Quality of Life Questionnaire scores in the treatment group was significantly better the control group Conclusions Ultrasound-guided acupuncture of the sphenopalatine ganglion can improves clinical symptoms of patients with allergic rhinitis.
目的 探讨孕中晚期口腔二维轴向切面超声在产前诊断胎儿唇腭裂中的应用价值,评估其对唇裂、唇腭裂及继发腭裂的检出率和准确性。方法 本研究为前瞻性研究,共纳入2020年3月—2023年12月在我院超声科行产前超声诊断的3 666例孕中晚期胎儿,其中经超声检查诊断出111例唇腭裂,这些病例归为唇腭裂组,其余3 555例归入正常对照组。所有受试者均通过口腔二维轴向切面超声进行评估,诊断结果经产后随访确认。结果 在正常对照组中,上唇及上牙槽突的评估成功率为100%,软硬腭分界线显示率为99%,软腭显示率为85%。在唇腭裂组中,超声对唇裂、唇腭裂及继发腭裂的检出率分别为45%、48%和7%,且超声诊断的灵敏度、特异度和预测值均超过98%。结论 孕中晚期口腔二维轴向切面超声在产前诊断胎儿唇腭裂中具有较高的准确性和可靠性,为早期干预和临床管理提供了重要的影像学依据。
Objective To explore the application value of two-dimensional axial section ultrasound in prenatal diagnosis of fetal cleft lip and palate in the second and third trimesters of pregnancy,and to evaluate its detection rate and accuracy for cleft lip,cleft lip and palate,and secondary cleft palate.Methods This study is a prospective study that included 3 666 fetuses in the second and third trimesters of pregnancy.Among them,111 cases of cleft lip and palate were diagnosed by ultrasound examination.These cases were classified as the cleft lip and palate group,and the remaining 3 555 cases were classified as the normal control group.All subjects were evaluated by oral two-dimensional axial section ultrasound,and the diagnostic results were confirmed by postpartum follow-up.Results In the normal control group,the success rates of evaluating the upper lip and upper alveolar process were 100%.The present rate of the soft hard palate boundary was 99%,and the present rate of the soft palate was 85%.In the cleft lip and palate group,the detection rates of cleft lip,cleft lip and palate,and secondary cleft palate by ultrasound were 45%,48% and 7% respectively,and the sensitivity,specificity,and predictive value of ultrasound diagnosis exceeded 98%.Conclusions Two dimensional axial section ultrasound of the oral cavity in second and third trimesters of pregnancy has high accuracy and reliability in prenatal diagnosis of fetal cleft lip and palate,providing strong imaging evidence for early intervention and clinical management.
目的 评估ChatGPT 4与Llama 3微调模型在乳腺癌诊断中的应用效果,特别是在超声、钼靶及超声联合钼靶的非结构化报告和影像诊断方面。方法 回顾性收集了689例同时接受乳腺超声和钼靶检查的患者数据,比较两种模型在文本和图像模态下的诊断性能,并探讨乳腺密度对模型表现的影响。结果 在文本模态下,微调Llama 3表现优异,联合诊断准确率达91.7%,优于ChatGPT 4的71.7%。图像模态中两模型准确率均低于70%,但ChatGPT 4灵敏度较高(78.3%),Llama 3特异度突出(98.3%)。分组分析表明,在非致密型乳腺中钼靶表现更佳,而致密型乳腺中超声诊断更具优势。结论 大语言模型在医学图像处理和多模态整合方面仍需进一步优化,医学领域微调的大语言模型在处理非结构化临床文本方面具有潜力。
Objective To evaluate the application effectiveness of ChatGPT 4 and the fine-tuned Llama 3 model in breast cancer diagnosis,particularly in processing unstructured reports and diagnostic imaging of ultrasound,mammography,and their combined modalities.Methods Retrospective data from 689 patients who underwent both breast ultrasound and mammography examinations were collected.The diagnostic performance of the two models was compared across text and image modalities,and the impact of breast density on model performance was explored.Results In the text modality,the fine-tuned Llama 3 model performed excellently,achieving a combined diagnostic accuracy of 91.7%,outperforming 71.7% of ChatGPT 4.In the image modality,both models had accuracies below 70%,but ChatGPT 4 exhibited higher sensitivity(78.3%),while Llama 3 demonstrated outstanding specificity(98.3%).Subgroup analysis indicated that mammography performed better in non-dense breasts,whereas ultrasound was more advantageous in dense breasts.Conclusions The large language models still require further optimization in medical image processing and multimodal integration,but fine-tuned large language models in the medical field show potential in handling unstructured clinical texts.
目的 探讨经颅多普勒超声(TCD)参数联合屏气指数在颈内动脉(ICA)狭窄或闭塞所致急性脑梗死的评估价值。方法 选择2022年1月—2024年12月,在广州市花都区人民医院连续入组发病72 h内ICA狭窄或闭塞所致的急性脑梗死患者。记录患者人口统计学资料、临床资料及TCD相关参数,包括搏动指数(PI)、阻力指数( RI)、大脑中动脉平均血流速度(Vm)及屏气指数等。依据患者数字减影血管造影(DSA)结果分为侧支循环良好组及侧支循环不良组。比较两组人口统计学、临床资料及TCD相关参数,采用单因素分析、多因素Logistic回归分析及ROC曲线。结果 共纳入ICA狭窄或闭塞所致急性脑梗死共136例,其中侧支循环良好组46例,侧支循环不良组90例。单因素分析提示:侧支循环良好组与侧支循环不良组在PI[0.95(0.80,1.03)vs 1.01(0.88,1.13)]、RI[0.58(0.51,0.62)vs 0.60(0.54,0.65)]、Vm[57(44,65)vs 50.5(41,63)]及屏气指数[0.78(0.75,0.85)vs 0.72(0.59,0.79)]方面,差异具有统计学意义(P<0.05)。多因素Logistic回归分析提示Vm(OR=1.029,95%CI:1.006~1.053,P=0.014)、屏气指数(OR=723.401,95%CI:14.524~3 6031.859,P<0.001)是侧支循环不良的独立危险因素。屏气指数和Vm评估侧支循环情况的ROC曲线下面积(AUC)分别为0.713(95%CI:0.627~0.799)和0.605(0.505~0.705),两者的AUC值比较差异无统计学意义(P>0.05)。结论 屏气指数和Vm可以评估ICA狭窄或闭塞所致急性脑梗死的侧支循环,屏气指数和Vm的评估效能相当。
Objective To explore the evaluation value of transcranial Doppler ultrasound(TCD)in acute cerebral infarction caused by internal carotid artery(ICA)stenosis or occlusion.Methods From January 2022 to December 2024,patients with acute cerebral infarction caused by ICA stenosis or occlusion within 72 hours of onset were enrolled in our hospital.Patient’s demographic data,clinical data,and TCD related parameters,including pulsatility index(PI),resistance index(RI),average blood flow velocity(Vm)of the middle cerebral artery,and breath holding index(BHI)were recorded.According to the results of digital silhouette angiography(DSA),patients were divided into good collateral group and poor collateral group.Demographic,clinical data,and TCD related parameters were compared between two groups using univariate analysis,multivariate Logistic regression analysis and ROC curve.Results A total of 136 cases of acute cerebral infarction caused by ICA stenosis or occlusion were included,including 46 cases in the collateral good group and 90 cases in the collateral poor group.Univariate analysis showed that the good collateral group and the poor collateral group were different in PI(0.95[0.80,1.03]vs 1.01[0.88,1.13]),RI(0.58[0.51,0.62]vs 0.60[0.54,0.65]),Vm(57[44,65]vs 50.5[41,63]),BHI(0.78[0.75,0.85] vs 0.72[0.59,0.79])(P<0.05).Multivariate Logistic regression analysis showed that Vm(OR=1.029,95%CI:1.006-1.053,P=0.014)and BHI(OR=723.401,95%CI:14.524-36 031.859,P<0.001)were independent risk factors for collateral circulation disorders.The area under the ROC curve(AUC)for predicting collateral circulation using BHI and Vm were 0.713(95%CI:0.627~0.799)and 0.605(0.505~0.705),respectively.There was no statistically significant difference in AUC values between the BHI and Vm.Conclusions The BHI and Vm can predict the collateral circulation of acute cerebral infarction caused by ICA stenosis or occlusion,and their predictive power is comparable.
目的 探讨肌骨超声(MSUS)在慢性肌肉骨骼疼痛(CMP)康复精准化教学中的应用效果。方法 选取在广州市第一人民医院南沙医院康复医学科实习的43名大专及本科学生,对照组进行常规CMP康复精准化教学,MSUS组在常规教学基础上增加MSUS辅助教学。实习结束后,通过专业理论考试和实践考核观察教学效果,并以问卷调查学生对教学形式和效果的满意度。结果 MSUS组的理论考核成绩为(84.62±5.14)分,对照组为(81.45±6.21)分,两组间差异无统计学意义(P>0.05)。MSUS组的实践考核成绩(4.71±1.06)分高于对照组(3.64±1.14)分(P<0.05)。问卷调查显示,MSUS组学生的总体满意度(35.24±3.43)高于对照组(32.64±3.98),P<0.05。其中,对于教学方法的满意度,MSUS组(9.81±0.60)高于对照组(8.82±1.18)(P<0.05);对于综合分析与实践能力的满意度,MSUS组(7.43±1.91)高于对照组(6.18±1.62)(P<0.05)。结论 MSUS教学在夯实学生专业基础知识、深化临床实践、提高综合分析能力和学习积极性方面具有显著优势,为精准化康复教学提供了有效手段。
Objective To explore the application effect of musculoskeletal ultrasound(MSUS)in the precise teaching of chronic musculoskeletal pain(CMP)rehabilitation.Methods Forty-three college and undergraduate students interning in Rehabilitation Medicine Department of Nansha Hospital,Guangzhou First People’s Hospital were selected,control group conducted conventional CMP rehabilitation teaching,and the MSUS group received additional MSUS-assisted teaching on the basis of the conventional teaching.After the internship,the teaching effectiveness was observed through professional theoretical examinations and practical assessments,and a questionnaire survey was conducted to evaluate students’satisfaction with the teaching methods and outcomes.Results The theoretical assessment score of the MSUS group were(84.62±5.14)and(81.45±6.21)of the control group,there was no difference between the two groups(P>0.05).The practical assessment scores of the MSUS group(4.71±1.06)were higher than those of the control group(3.64±1.14),and a significant difference was found between the two groups(P<0.05).The questionnaire survey showed that the overall satisfaction of the MSUS group students(35.24±3.43)was higher than that of the control group(32.64±3.97)(P<0.05).Among them,satisfaction with the teaching method was higher in the MSUS group(9.81±0.60)than in the control group(8.82±1.18)(P<0.05),satisfaction with comprehensive analysis and practical ability was also higher in the MSUS group(7.43±1.91)than in the control group(6.18±1.62)(P<0.05).Conclusions MSUS teaching has significant advantages in consolidating students’basic professional knowledge,deepening clinical practice,improving comprehensive analysis ability and learning enthusiasm.It provides an effective means for precise rehabilitation teaching.
目的 探讨超声引导下腹横肌平面阻滞(TAP)联合无阿片药全身麻醉(全麻)在腹腔镜子宫全切术中的应用效果。方法 选取武威市凉州医院2021年5月—2023年5月收治的60例择期行腹腔镜子宫全切术患者展开前瞻性研究,应用抽签法将其分为观察组与对照组,各30例。对照组患者实施常规阿片类药物全麻,观察组采用TAP联合无阿片药全身麻醉。对比两组患者入室后(T0)、切皮时(T1)、手术10 min后(T2)和手术结束即刻(T3)生命体征变化,麻醉后监测治疗室(PACU)恢复情况,术后1、4、8、12、24、48 h疼痛程度,最后对比其48 h内不良反应发生率。结果 两组T0、T1、T2、T3时间血氧饱和度(SpO2),T0、T3时间平均动脉压(MAP)、心率水平无明显变化,两组对比差异无统计学意义(P>0.05),T1、T2时间对照组MAP、心率升高,观察组T1、T2的MAP、心率均低于对照组(P<0.05);观察组PACU停留时间、首次肛门排气时间明显低于对照组(P<0.05);观察组术后1、4、8、12、24、48 h活动时视觉模量表(VAS)评分与静息时VAS评分低于对照组(P<0.05);观察组术后48 h内不良反应发生率比对照组更低(P<0.05)。结论 针对腹腔镜子宫全切术患者采取超声引下TAP联合无阿片药全麻可稳定患者术中生命体征,缩短患者术后恢复时间,减轻疼痛程度,且可降低术后48 h内不良反应发生率。
Objective To explore the application effect of ultrasound-guided transverse abdominis plane(TAP)block combined with opioid-free general anesthesia in laparoscopic total hysterectomy.Methods A prospective study was conducted in 60 patients who underwent selective laparoscopic total hysterectomy in Wuwei Liangzhou Hospital from May 2021 to May 2023.They were divided into a observation group and a control group using a lottery method,30 cases in each group.The control group received routine opioid general anaesthesia,while the observation group received TAP in combination with opioid-free general anaesthesia.Comparing the changes of vital signs after invasion(T0),skin cutting(T1),10 min after operating(T2),the end of surgery(T3),and condition in the post-anesthesia care unit(PACU)after anesthesia,the pain degree at 1 h,4 h,8 h,12 h,24 h and 48 h after surgery,and the incidence of adverse reactions within 48 h.Results There were no significant changes in blood SpO2,mean arterial pressure(MAP)and heart rate at T0,T1,T2 and T3 in both groups,and no significant difference between the two groups(P>0.05).MAP and heart rate increased in the control group at T1 and T2,while those in the observation group were lower than the control group(P<0.05).The observation group had significantly shorter PACU time and first anal exhaust time than the control group(P<0.05).VAS scores at 1 h,4 h,8 h,12 h,24 h and 48 h after surgery and VAS score at rest in the observation group were lower than in the control group(P<0.05).The incidence of adverse reactions within 48 h after surgery was lower in the observation group than in the control group(P<0.05).Conclusions Ultrasound guided TAP combined with opioid-free general anesthesia can stabilize intraoperative vital signs,shorten postoperative recovery time,alleviate postoperative pain,and reduce the incidence of anesthesia related adverse reactions within 48 hours for patients undergoing laparoscopic total hysterectomy.
目的 探讨产时超声管理妊娠期糖尿病产妇产程的应用价值。方法 选择2022年1月1日—2023年12月31日在佛山市高明区人民医院妇产科分娩的妊娠期糖尿病初产妇共100例。患者签署知情同意书后, 按照1∶1比例采用随机数字表法分为对照组和研究组各50例。对照组采用阴道指诊检查判断产程和分娩方式。研究组采用经腹联合会阴超声测量检查判断产程及分娩方式。收集两组初产妇血糖、血常规、分娩方式、产后24 h出血量以及切口情况, 新生儿Apgar评分。结果 研究组阴道分娩率高于对照组(88.0% vs 72.0%, P<0.05), 而阴道检查次数(4.18±0.8 vs 6.82±0.8, P<0.05)少于对照组、不良事件发生率(4% vs 16%, P<0.05)低于对照组。相对于对照组,研究组血红蛋白水平较高(104.10±5.25 vs 100.30±4.78, P<0.05)、而白细胞计数(11.40±1.49 vs 12.04±1.66, P<0.05)以及中性粒细胞百分比较低(72.79±4.04 vs 75.01±5.53, P<0.05)。结论 通过产时超声监测判断妊娠期糖尿病初产妇产程,能够降低阴道操作引起的感染等风险,提高阴道分娩率,有效降低产妇感染,提高产妇分娩满意度以及舒适度,改善母婴结局。
Objective To explore the application value of intrapartum ultrasound for labor management of pregnant women with gestational diabetes mellitus.Methods A total of 100 primiparous women with gestational diabetes mellitus who gave birth in the Obstetrics and Gynecology Department of Foshan Gaoming District People’s Hospital from January 1, 2022 to December 31, 2023 were selected.After signing the informed consent form, the patients were randomly divided into a control group and a study group with 50 cases in each group according to a ratio of 1∶1, using a random number table method.The control group underwent vaginal digital examination to assess the labor process and delivery method.For the study group, the labor process and delivery mode were determined using transabdominal ultrasound measurement.Blood glucose level,routine blood test results, delivery methods, 24-hour postpartum bleeding volume and incision conditions of two groups of primiparas, as well as the Apgar score of newborns were collected.Results The study group demonstrated a significantly higher vaginal delivery rate than the control group(88.0% vs 72.0%, P<0.05), with fewer vaginal examinations(4.18±0.80 vs 6.82±0.80, P<0.05)and a lower incidence of adverse events(4% vs 16%, P<0.05).Compared to the control group, the study group exhibited higher hemoglobin levels([104.10±5.25]g/L vs [100.30±4.78] g/L, P<0.05), but lower white blood cell counts([11.40±1.49]×109/L vs [12.04±1.66]×109/L, P<0.05)and reduced neutrophil percentages([72.79±4.04]% vs [75.01±5.53]%, P<0.05).Conclusions Intrapartum ultrasound monitoring for assessing labor progression in primiparas with gestational diabetes mellitus reduces infection risks associated with vaginal procedures, increases vaginal delivery rates, effectively decreases maternal infections, enhances maternal satisfaction and comfort during delivery,and improves maternal-neonatal outcomes.
目的 探讨超声弹性成像联合高频超声在甲状腺乳头状癌诊断中的应用价值。方法 2022年1月—2023年6月选择在中国人民解放军联勤保障部队第九九〇医院诊治的疑似甲状腺乳头状癌患者82例,所有患者均给予超声弹性成像联合高频超声检查,记录超声特征。所有患者均行病理检查,并以病理检查作为判断的金标准。结果 在82例患者中,病理诊断为甲状腺乳头状癌48例(癌性组),占比58.54%;甲状腺良性结节34例(良性组),占比41.46%。癌性组的形态异常、后方回声衰减、钙化、晕环征、边界不清晰、内部低回声等超声征象占比为81.25%、83.33%、83.33%、83.33%、81.25%、81.25%,高于良性组的52.94%、47.06%、47.06%、41.18%、47.06%、52.94%(P<0.05)。癌性组的收缩期最高流速低于良性组(P<0.05),阻力指数、搏动指数与良性组相比有提高(P<0.05)。癌性组的弹性成像评分多为3~4分,良性组多为2分,两组比较差异有统计学意义(P<0.05)。超声弹性成像联合高频超声判断为甲状腺乳头状癌47例,诊断中的灵敏度与特异度分别为97.92%(47/48)和100.00%(34/34)。结论 甲状腺乳头状癌在超声上多表现为血流信号异常、钙化、后方回声衰减、晕环征等特征,超声弹性成像评分多为3~4分,超声弹性成像联合高频超声在其诊断中具有较高的应用价值。
Objective To explore the application value of ultrasound elastography combined with high-frequency ultrasound in the diagnosis of papillary thyroid cancer(PTC).Methods From January 2022 to June 2023,82 patients with suspected PTC were treated at Chinese People’s Liberation Army Joint Logistics Force 990 Hospital.All patients were given ultrasound elastography combined with high-frequency ultrasound examination to record ultrasound features.All cases were given pathological examination,and the pathological examination were used as the gold standard for diagnosis.Results Among the 82 patients,48 were PTC(cancerous group),accounting for 58.54%;and the other 34 were benign thyroid nodules(benign group),accounting for 41.46%.The proportion of morphological abnormalities,posterior echo attenuation,calcification,halo ring signs,unclear boundary and internal hypoechoics in cancerous group were 81.25%,83.33%,83.33%,83.33%,81.25% and 81.25%,which were significantly higher than 52.94%,47.06%,47.06%,41.18%,47.06% and 52.94% in the benign group(P<0.05).The highest systolic flow velocity in the cancerous group was significantly less than that in the benign group(P<0.05),and the resistance index and pulse index were also significantly higher compared with the benign group(P<0.05).The elastography score were mostly 3~4 in the cancerous group and 2 in the benign group,with a significant difference between the two groups(P<0.05).Forty-seven cases of PTC were diagnosed by ultrasound elastography combined with high frequency ultrasonography,and the sensitivity and specificity in diagnosis were 97.92%(47/48)and 100.00%(34/34),respectively.Conclusions PTC is often characterized by abnormal blood flow signals,calcification,posterior echo attenuation,halo sign and so on.The ultrasound elastography score is usually 3~4 points.Ultrasonic elastography combined with high frequency ultrasound has high value in diagnosis of PTC.
目的 探讨常规超声心动图联合二维斑点追踪技术评估急性白血病患儿在接受蒽环类药物治疗后产生的心脏毒性,早期检测左心功能障碍。方法 采用前瞻性非随机观察研究,选取新诊断急性淋巴细胞白血病患儿20例,分别于确诊白血病后接受蒽环类药物治疗前、接受所有蒽环类药物剂量后以及确诊白血病1年后,进行常规超声心动图和二维斑点技术监测评估心脏毒性。结果 左室流出道速度积分TVI和E、E/E’在治疗期间下降,并在诊断后1年恢复至治疗前数值。在二维斑点追踪纵向应变中,GLPS-LAX、GLPS-A2C、LV-GLPS在完成所有蒽环类药物剂量后与诊断后比较差异有统计学意义,以及诊断后1年与蒽环类药物治疗后比较差异有统计学意义。但GLPS-A4C各时间点比较差异无统计学意义。结论 常规超声心动图联合二维斑点追踪技术的纵向整体应变可早期发现白血病患儿化疗所致的左室功能障碍。
Objective To evaluate cardiotoxicity in children with acute lymphoblastic leukemia treated with anthracyclines by echocardiography combined with 2D speckle tracking imaging,and to detect left heart dysfunction early.Methods In this prospective nonrandomized study,20 children with newly diagnosed acute lymphoblastic leukemia were assessed for cardiotoxicity by echocardiography and 2D speckle tracking imaging in three periods during the treatment.Results The left ventricular outflow tract velocity integral TVI and E,E/E’ decreased during treatment,and went back to the pre-treatment value one year after diagnosis.In the longitudinal strain of 2D speckle tracking imaging,in GLPS-LAX,GLPS-A2C,LV-GLPS,there were statistical differences between treatment completed and after diagnosis,and between 1 year after diagnosis and treatment completed.However,GLPS-A4C has no statistical significance.Conclusion sThe conventional echocardiography combined with longitudinal overall strain of 2D speckle tracking imaging can comprehensively evaluate the early changes of left ventricular dysfunction caused by chemotherapy in children with leukemia.