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[霍奇金病的迟发性心脏毒性。脉冲多普勒超声心动图研究]

[Late cardiac toxicity in Hodgkin's disease. A study with pulsed Doppler echocardiography].

作者信息

Völler H, Kreuser E D, Uhrig A, Schröder K, Behles C, Thiel E, Schröder R

机构信息

Abteilung für Innere Medizin mit Schwerpunkt Kardiologie und Pulmologie, Freie Universität Berlin.

出版信息

Dtsch Med Wochenschr. 1993 Feb 26;118(8):247-53. doi: 10.1055/s-2008-1059323.

Abstract

49 patients (22 women, 27 men, mean age 43.7 [21-65] years) with Hodgkin's disease were examined by Doppler echocardiography a median of 5.37 (2-10) years after the end of chemotherapy (given according to the COPP/ABVD scheme, with or without mediastinal irradiation) for possible chronic changes in myocardium, pericardium or cardiac valves, as well as for any haemodynamic sequelae. Maximal and integrated early (E, Ei) and late (A, Ai) diastolic flow velocities and their ratio (E/A, Ei/Ai) were measured by pulsed Doppler over the mitral and tricuspid valves. Although on two-dimensional echo 21 patients (42.9%) were found to have valvar thickening, 19 (38.8%) pericardial thickening and 9 (18.4%) a reduced fibre shortening fraction, the Doppler indices were statistically not significantly different from those in 25 controls with normal hearts. These echocardiographic data of functional and morphological parameters indicate that there was no effect on various measurements of diastolic function after chemotherapy with or without mediastinal radiation. In successfully treated patients with Hodgkin's disease the described changes are of minor significance.

摘要

对49例霍奇金病患者(22例女性,27例男性,平均年龄43.7[21 - 65]岁)在化疗结束后(根据COPP/ABVD方案给予化疗,有或没有纵隔照射)中位时间5.37(2 - 10)年进行了多普勒超声心动图检查,以观察心肌、心包或心脏瓣膜可能出现的慢性变化以及任何血流动力学后遗症。通过脉冲多普勒测量二尖瓣和三尖瓣上的最大和综合早期(E,Ei)及晚期(A,Ai)舒张期血流速度及其比值(E/A,Ei/Ai)。虽然二维超声心动图检查发现21例患者(42.9%)有瓣膜增厚,19例(38.8%)有心包增厚,9例(18.4%)有纤维缩短分数降低,但多普勒指标与25例心脏正常的对照组相比在统计学上无显著差异。这些功能和形态学参数的超声心动图数据表明,无论有无纵隔放疗,化疗后对舒张功能的各项测量均无影响。在成功治疗的霍奇金病患者中,所描述的这些变化意义不大。

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