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目的:探讨世界超声心动图联盟(WASE)心脏超声正常值研究对抗肿瘤治疗相关心脏毒性超声评估指标的影响。方法:选取2017年3月至2018年3月山东大学齐鲁医院37例接受蒽环类药物化疗的乳腺癌患者，分别在化疗前基础状态(T0)及化疗第2周期(T2)、第4周期(T4)、第6周期(T6)结束后行超声心动图检查，根据美国超声心动图学会(ASE)左室射血分数(left ventricular ejection fraction，LVEF)正常值下限(lower limit of normal left ventricular ejection fraction，LVEF-LLN)为53%、欧洲心脏病学学会(ESC)指南(LVEF-LLN为50%)以及WASE研究LVEF-LLN标准(多中心女性为58%，亚洲女性为59%)评估化疗过程中出现心肌损伤患者的例数，并与以左室整体纵向应变(global longitudinal strain，GLS)为标准定义的亚临床心肌损伤患者例数比较，分析不同心肌损伤判断标准患者构成比的变化。结果:随着LVEF-LLN的提高，使用LVEF评估蒽环类药物相关心脏毒性可发现更多早期心肌损伤患者，以LVEF下降10%且LVEF低于50%(2016 ESC指南)为标准时1例出现抗肿瘤治疗相关心肌损伤(cancer therapy related cardiac dysfunction，CTRCD)；LVEF-LLN为53%(2014 ASE指南)时3例出现CTRCD；按照WASE研究女性群体LVEF-LLN为58%时7例出现CTRCD；以亚洲女性LVEF-LLN 59%为标准时9例出现CTRCD；各种以LVEF为标准判断心肌损伤例数均少于使用GLS监测发现的亚临床心肌损伤例数(18例)，但LVEF下降10%且LVEF低于59%标准与GLS标准的敏感性差异无统计学意义(n P>0.05)。n 结论:LVEF-LLN上调后，使用LVEF评估早期心肌损伤的敏感性提高，但GLS仍是监测抗肿瘤治疗相关早期心肌损伤最敏感的指标。“,”Objective:To explore the influence of the value of the echocardiography in the detection of cancer therapeutics-related cardiotoxicity by World Alliance Societies of Echocardiography(WASE) study.Methods:Tirty-seven breast cancer patients underwent echocardiography at baseline before chemotherapy (T0) and after the second (T2), fourth (T4), sixth (T6) chemotheraphy cycles in Qilu Hospital of Shandong University from March 2017 to March 2018. According to different guidelines[ASE lower limit of normal left ventricular ejection fraction(LVEF-LLN) 53%, ESC LVEF-LLN 50% and the WASE study (Women LVEF-LLN 58%, Asian Women LVEF-LLN 59%)], the number of patients with myocardial injury during chemotherapy was evaluated, and compared with the global longitudinal strain(GLS) standard, the percentages of patients with myocardial injury in different standards were analyzed.Results:With the up-regulation of LVEF-LLN, more patients with early myocardial damage were found. During chemotherapy, 1 patient showed left ventricular ejection fraction (LVEF) fell by >10% from baseline to LVEF10% from baseline to LVEF10% from baseline to LCVEF10% from baseline to LVEF10% from baseline to LVEF0.05).n Conclusions:With the up-regulation of LVEF-LLN, the sensitivity of LVEF in evaluating early myocardial damage was increased, but GLS was still the most sensitive index to monitor the cancer therapeutics-related myocardial damage.