三维斑点追踪成像结合二维超声评价不同程度肺动脉高压患者左心功能

发布时间：2018-01-02 15:31

本文关键词：三维斑点追踪成像结合二维超声评价不同程度肺动脉高压患者左心功能　出处：《中国医学影像学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的应用三维斑点追踪成像(3D-STI)结合二维超声定量评价肺动脉高压(PH)患者左心室收缩及舒张功能,探讨不同程度PH对左心室功能的影响。资料与方法回顾性分析2011年9月-2015年11月在吉林大学第一医院52例诊断为PH患者的临床资料,并根据肺动脉收缩压(PASP)分为轻度组(PASP 36~49 mmHg,n=20)、中度组(PASP 50~70 mmHg,n=18)、重度组(PASP70 mmHg,n=14);同时选取健康志愿者作为对照组(n=30)。所有研究对象均留取二维及三维图像,利用二维超声获取左心室内径(LVDd)、左心室射血分数(LVEF)、左心房最大容积指数(LAVI)、PASP、e'及E/e'等指标;利用3D-STI获取左心室整体纵向应变(GLS)、左心室整体径向应变(GRS)、左心室整体圆周应变(GCS)及左心室整体面积应变(GAS)等指标。对比不同组间参数,分析PASP与左心收缩及舒张功能指标的相关性。结果 E/e'及LAVI在中度组、重度组较对照组均明显升高,差异有统计学意义(P0.05);GLS及GAS在中度组绝对值较对照组减低,差异有统计学意义(P0.05);重度组GLS、GRS、GCS及GAS绝对值均较对照组减低,差异有统计学意义(P0.05)。相关性分析显示,二维参数中LAVI和PASP相关性较好(r=0.56,P0.01);三维应变数值中GLS绝对值与PASP相关性较好(r=0.60,P0.01)。结论 3D-STI结合二维超声能够有效评估PH患者左心收缩及舒张功能受损情况,为临床早期干预治疗提供理论支持。
[Abstract]:The purpose of the application of three-dimensional speckle tracking imaging (3D-STI) combined with pulmonary hypertension by two-dimensional ultrasound (PH) quantitative assessment of left ventricular systolic and diastolic function in patients with different degrees of PH, to explore the function of the left ventricle. Materials and methods of analysis of the September 2011 -2015 year in November in No.1 Hospital of Jilin University clinical data of 52 patients with PH were retrospectively, and according to the lung the systolic blood pressure (PASP) were divided into mild group (PASP 36~49, mmHg, n=20), moderate group (PASP 50~70 mmHg, n=18), severe group (PASP70 mmHg, n=14); at the same time selected healthy volunteers as control group (n=30). All subjects were collected with 2D and 3D images obtained by left ventricular diameter two dimensional ultrasound (LVDd), left ventricular ejection fraction (LVEF), maximum left atrial volume index (LAVI), PASP, E'and E/e' were obtained by using the 3D-STI; left ventricular global longitudinal strain (GLS), left ventricular global radial strain (GRS), left heart The circumferential strain (GCS) and left ventricular global area strain (GAS) and other indicators. Comparison between different groups of parameters, correlation analysis of the PASP and the left ventricular systolic and diastolic function indexes. The results of E/e'and LAVI in the moderate group, severe group than in the control group were significantly increased, the difference was statistically significant (P0.05); GLS and the absolute GAS value lower than the control group in the moderate group, the difference was statistically significant (P0.05); severe group GLS, GRS, GCS and GAS absolute values were lower than those in control group, the difference was statistically significant (P0.05). Correlation analysis showed that the two parameters of LAVI and PASP have good correlation (r=0.56, P0.01); D numerical in the absolute value of GLS correlated well with PASP (r=0.60, P0.01). Conclusion 3D-STI combined with two-dimensional ultrasound can effectively assess left ventricular systolic and diastolic function in patients with PH damage, provide theoretical support for the clinical treatment of early intervention.

【作者单位】：吉林大学第一医院心脏超声科;
【基金】：吉林省科技发展计划项目(2015Y034-4)
【分类号】：R540.45;R544.1
【正文快照】： 表2　二维参数与PASP的相关性二维参数r值P值LVDd-0.37 0.01LVEF-0.14 0.05E/e'0.40 0.05e'-0.45 0.01LAVI 0.56 0.012.2　PH组与对照组3D-STI数值比较　PH轻度组各指标与对照组比较,差异均无统计学意义(P0.05);PH中度组仅GLS和GAS较对照组差异有统计学意义(P0.05);PH重度组

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