目的: 乳腺癌病人在接受蒽环类药物化疗药物后采用超声三维斑点追踪技术评估早期左心室功能 改变，并探讨左室整体三维应变参数对检测化疗所致心脏毒性的价值。方法: 收集我院 2016－03 ～ 2018－03 期间 接受外科手术治疗后的女性乳腺癌病人 30 例，均接受 6 周期的 TAC 联合化疗方案。分别检测病人接受 3 DST 后的化疗前基础状态、化疗 3 周期、化疗 6 周期后的左室壁整体收缩期应变参数，包括整体纵向应变( GLS) 、径 向应变( GＲS) 、圆周应变( GCS) 及面积应变( GAS) ，同时应用普通二维超声心动图采集左室舒张末容积( LV- EDV) ，左室收缩末容积( LVESV) ，左室射血分数( LVEF) ，每搏输出量( SV) ，二尖瓣口血流频谱 E/A 值。结果: ( 1) 与化疗前比较，化疗 3 周期及 6 周期后病人左室 EDV、ESV、LVEF、SV 及 E/A 差异均无统计学意义; ( 2) 化疗 3 周期完成后左室 GLS 较化疗前减低，差异有统计学意义; 6 周期化疗完成后左室 GLS、GAS 均较化疗前显著减 低，差异有统计学意义。结论: 蒽环类药物的心脏毒性具有剂量累积性，且早期损害不易显现。三维超声斑点追 踪技术可以早期发现蒽环类药物所引起的心肌损害，为临床及时调整方案并进行个体化治疗提供重要信息。

Objective: To assess the clinical significance of three－dimensional speckle tracking ima- ging( 3 DST) in the evaluation of left ventricular myocardial function in breast cancer survivors with postoperative anthracycline － based chemotherapy． Methods: This thesis selects 30 breast cancer survivors with postoperative anthracycline －based chemotherapy over the period from March，2016 to March，2018．Three－dimensional speckle tracking echocardiography was performed before chemotherapy and after 3 and 6 anthracycline－based chemotherapeutic cycles，to assess the left ventricle’s global three－dimensional strain．Conventional echocardiography was performed before chemotherapy and after 3 and 6 anthracycline－based chemotherapeutic cycles．Ｒesults: In comparison with baseline cases，no statistical difference in LVEDV，LVESV，LVEF，SV，E /A showed during and after the treatment．GLS and GAS were reduced after 3 cycles of treatment，and significantly decreased after 6 cycles of treat- ment．GCS and GＲS were decreased but didn’t show statistically significant after the last cycle of treat- ment．Conclusion: Cardiac toxicity caused by anthracycline is cumulative，and the early damage is hid-den．Three－dimensional speckle－tracking echocardiography rovides a new sensitive and early method to evaluate early cardiac toxicity caused by anthracycline antineoplastic drugs compared with conventional echocardiography

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