斑点追踪技术评价系统性硬化病患者心室功能

发布时间：2018-05-03 01:03

  本文选题：硬化病 + 斑点追踪成像　； 参考：《川北医学院》2015年硕士论文

【摘要】：目的:应用三维超声斑点追踪成像技术(3D-STI)评价系统性硬化病(SSc)患者左心室整体收缩功能,并探讨各整体应变指标诊断SSc心脏损害的应用价值。方法:选取临床确诊SSc患者34例,其中弥漫皮肤型(dc SSc)18例,局限皮肤型(lc SSc)16例,正常健康对照组22例。采集标准心尖四腔心三维全容积图像,运用3D-STI软件脱机分析得出左心室整体面积收缩期峰值应变(GAS)、整体圆周收缩期峰值应变(GCS)、整体纵向收缩期峰值应变(GLS)、整体径向收缩期峰值应变(GRS)及左心室射血分数(LVEF)等,比较SSc组与正常对照组各指标的变化情况。应用受试者操作特征(ROC)曲线分析各整体应变值对SSc患者左心室损害的诊断价值。结果:SSc组左心室GAS、GCS、GLS及GRS较正常对照组均减低(分别为-26.3±3.3%、-16.7±2.9%、-15.9±2.6%、40.7±8.3%对-31.1±2.8%、-18.5±2.5%、-19.2±1.8%、-46.4±10.3%),且差异有统计学意义(P均0.05);dc SSc组左心室GAS、GCS、GLS及GRS较lc SSc组均减低(分别为-25.1±3.3%、-15.9±2.7%、-15.0±2.4%、39.7±8.0%对-27.6±2.9%、-17.6±3.0%、-16.8±2.6%、41.8±8.8%),其中GAS和GLS差异有统计学意义(P0.05)。ROC曲线显示GAS诊断SSc左心室损害的AUC最大,为0.877,当GAS截断值为�c29.34%时,其灵敏度为88.2%,特异度为77.3%。结论:SSc患者左心室纵向、环向及径向收缩功能均已存在不同程度的受损,3D-STI可早期评价SSc患者的左心室整体收缩功能改变,在各项应变指标中,以GAS诊断SSc心脏损害的准确度最高。目的:应用二维斑点追踪成像(2D-STI)技术评价系统性硬化病(SSc)患者右心室心肌功能的变化。方法:34例SSc患者,其中弥漫皮肤型(dc SSc)18例,局限皮肤型(lc SSc)16例,健康对照组22例,接受经胸超声心动图检查。应用2D-STI测量右心室侧壁整体收缩期纵向峰值应变(GLS)及收缩期、舒张早期、舒张晚期整体纵向峰值应变率(GLSRs、GLSRe、GLSRa),比较SSc组与正常对照组及dc SSc组与lc SSc组各指标的变化情况。分析SSc组GLS与肺动脉收缩压(PASP)及病程的相关性。结果:①SSc组与对照组比较,GLS、GLSRs及GLSRe均降低,且差异均有统计学意义(P均0.05),GLSRa无明显差异;dc SSc组与lc SSc组比较,GLS、GLSRs及GLSRe均降低,其中GLS及GLSRe差异有统计学意义(P均0.05),GLSRa无明显差异。②SSc组GLS与PASP及病程均呈负相关(r=-0.447,P=0.008;r=-0.500,P=0.003)。结论:SSc患者右心室收缩及舒张功能均降低,dc SSc患者较lc SSc患者受损更严重。2D-STI可准确评价右心室功能改变,其GLS与病程、PASP有一定的相关性。
[Abstract]:Objective: to evaluate the global systolic function of left ventricle in patients with systemic sclerosis (SSC) by using 3D ultrasonic speckle tracing imaging (3D-STI) and to evaluate the value of global strain indices in the diagnosis of SSc cardiac damage. Methods: 34 patients with SSc were selected, including diffuse skin type SSc)18, localized skin type SSc)16 and normal control group (22 cases). Three dimensional full-volume images of standard apical four-chamber heart were collected. 3D-STI software was used to analyze the peak systolic strain of left ventricular whole area (GASA), the peak strain of whole circumferential systolic period (GCSS), the peak strain of whole longitudinal systolic period (GLSN), the peak strain of global radial systolic period (GRS) and the left ventricular ejection fraction (LVEF), etc. The changes of each index in SSc group and normal control group were compared. The diagnostic value of global strain values for left ventricular damage in patients with SSc was analyzed by using the operating characteristics of subjects. 缁撴灉:SSc缁勫乏蹇冨��GAS,GCS,GLS鍙奊RS杈冩�ｅ父瀵圭収缁勫潎鍑忎剑�

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