二维斑点追踪成像技术评价妊娠高血压孕妇左室功能改变的临床应用价值
发布时间：2019-03-27 14:52
【摘要】：目的应用二维斑点追踪成像(STI)技术对妊娠高血压孕妇不同孕期左心室功能改变进行分析。方法选取妊娠高血压组(PIH)48例,正常妊娠组45例,正常对照组45例,分别采集六组切面:心尖水平短轴切面、二尖瓣乳头肌水平短轴切面、左室心底水平短轴切面、胸骨旁左室长轴切面、胸骨旁左心两腔心切面、心尖四腔心切面,同步记录心电图,选取3-4个周期,导入QLAB工作站进行分析,记录纵向运动应变、径向运动应变、圆周运动应变、旋转运动应变、纵向应变率、径向应变率、圆周应变率、旋转应变率及整体扭转角度峰值(Ptw)、心底水平旋转角度峰值(Prot-MV)、心底水平旋转角度达峰绝对时间(Pti-MV)及达峰时间百分比(Perc-Pti-MV)、心尖水平旋转角度峰值(Prot-AP)、心尖水平旋转角达峰绝对时间(Pti-AP)及达峰时间百分比(Perc-Pti-AP)。结果1、妊娠高血压组及正常妊娠组纵向运动应变、径向运动应变、圆周运动应变、旋转运动应变、纵向应变率、径向应变率、圆周应变率、旋转应变率均较对照组明显减低(P0.05);妊娠高血压组纵向运动应变、径向运动应变、圆周运动应变、旋转运动应变、纵向应变率、径向应变率、圆周应变率、旋转应变率均较正常妊娠组(P0.05);妊娠高血压组晚期纵向运动应变、径向运动应变、圆周运动应变、旋转运动应变、纵向应变率、径向应变率、圆周应变率、旋转应变率低于中期(P0.05);2、妊娠高血压组与正常妊娠组对比,妊娠高血压组左室17节段中的12节段的心肌的面积峰值应变减低,集中于下壁、室间隔及心尖部;3、Prot-AP、Pti-AP、Perc-Pti-MV、Perc-Pti-AP、Ptw在妊娠高血压组及正常妊娠组孕中期水平高于正常对照组(P0.05),Prot-AP在妊娠高血压组孕中、晚期水平高于正常妊娠组(P0.05)且Pti-AP、Ptw在妊娠高血压组孕晚期水平高于正常妊娠组(P0.05),Prot-AP、Ptw在妊娠高血压组孕晚期水平高于同组孕中期(P0.05),Pti-Mv在妊娠高血压组及正常妊娠组孕中期水平低于正常对照组(P0.05)而Pti-AP在妊娠高血压组及正常妊娠组孕中期水平高于正常对照组(P0.05),Perc-Pti-AP在妊娠高血压组及正常妊娠组孕中期水平高于正常对照组(P0.05),而Perc-Pti-MV水平在两组间孕中期比较无统计学差异;结论1.与正常孕妇组比较,LVEF正常的妊高症孕妇左室收缩功能已经发生改变,且随着孕周的增大,收缩功能的减低更为明显。2..2DSTI技术没有角度依赖性,可重复性较好,测量过程也相对简便,可以综合评价左室收缩期纵向、径向、圆周应变及旋转、扭转角度的改变,从而更准确地评价左室整体及局部心肌功能。
[Abstract]:Objective To analyze the changes of left ventricular function during pregnancy with two-dimensional spot-tracking imaging (STI) technique. Methods Forty-eight cases of pregnancy-induced hypertension (PIH),45 cases of normal pregnancy group and 45 cases of normal control group were divided into six groups: apical horizontal short axis section, mitral valve papillary muscle horizontal short axis section, left ventricular bottom horizontal short axis section, and left ventricular long axis section of the sternum. the heart-cutting surface of the left heart and the apical four-cavity heart-cutting surface beside the sternum are synchronously recorded, the electrocardiogram is synchronously recorded,3-4 cycles are selected, the QLAB working station is introduced for analysis, the longitudinal motion strain, the radial motion strain, the circular motion strain, the rotational motion strain, the longitudinal strain rate and the radial strain rate are recorded, the circumferential strain rate, the rotational strain rate, the total torsional angle peak (ptw), the bottom-bottom horizontal rotation angle peak (Prot-MV), the bottom-bottom horizontal rotation angle, the peak absolute time (Pti-MV), and the peak-to-peak time percentage (Perc-Pti-MV), the apex-level rotation angle peak (Prot-AP), Apex horizontal rotation angle peak absolute time (Pti-AP) and peak time percentage (Perc-Pti-AP). Results: The longitudinal movement strain, the radial movement strain, the circular motion strain, the rotational movement strain, the longitudinal strain rate, the radial strain rate, the circumferential strain rate and the rotational strain rate of the pregnancy and the normal pregnancy group were lower than that of the control group (P0.05). The longitudinal movement strain, the radial movement strain, the circular motion strain, the rotational movement strain, the longitudinal strain rate, the radial strain rate, the circumferential strain rate and the rotational strain rate of the pregnancy and hypertension group were higher than that in the normal pregnancy group (P0.05); and the late-stage longitudinal movement strain and the radial movement strain of the pregnancy and hypertension group, the circular motion strain, the rotational motion strain, the longitudinal strain rate, the radial strain rate, the circumferential strain rate and the rotational strain rate are lower than the middle term (P0.05); and 2, the pregnancy hypertension group is compared with the normal pregnancy group, The peak strain of the myocardium in the 12-segment of the left ventricular segment of the hypertensive group was lower than that in the lower wall, the interventricular septum and the apex.3, Prot-AP, Pti-AP, Perc-Pti-MV, Perc-Pti-AP and Ptw were higher than those in the normal control group (P0.05). The advanced level of Prot-AP in the pregnancy induced hypertension group was higher than that in the normal pregnancy group (P0.05), and the level of Pti-AP and Ptw in the pregnancy-induced hypertension group was higher than that in the normal pregnancy group (P0.05), and the prot-AP and Ptw were higher in the first trimester of pregnancy than in the same group (P0.05). The medium-term level of Pti-Mv in the pregnancy and the normal pregnancy group was lower than that of the normal control group (P0.05), while the medium-term level of the Pti-AP in the pregnancy and the normal pregnancy group was higher than that of the normal control group (P0.05), and the level of the Perc-Pti-AP in the pregnancy and the normal pregnancy group was higher than that in the normal control group (P0.05). The Perc-Pti-MV level was not statistically different between the two groups; Conclusion 1. Compared with the normal pregnant women group, the left ventricular systolic function of the normal pregnant women with LVEF has changed, and the reduction of the contraction function is more obvious with the increase of the gestational period. 2 DSTI has no angular dependence, the repeatability is good, the measurement process is relatively simple, the left ventricular systolic longitudinal, the radial, the circumferential strain and the rotation and the torsion angle can be comprehensively evaluated, so that the whole and the local myocardial function of the left ventricle can be more accurately evaluated.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R714.246
本文编号：2448281
[Abstract]:Objective To analyze the changes of left ventricular function during pregnancy with two-dimensional spot-tracking imaging (STI) technique. Methods Forty-eight cases of pregnancy-induced hypertension (PIH),45 cases of normal pregnancy group and 45 cases of normal control group were divided into six groups: apical horizontal short axis section, mitral valve papillary muscle horizontal short axis section, left ventricular bottom horizontal short axis section, and left ventricular long axis section of the sternum. the heart-cutting surface of the left heart and the apical four-cavity heart-cutting surface beside the sternum are synchronously recorded, the electrocardiogram is synchronously recorded,3-4 cycles are selected, the QLAB working station is introduced for analysis, the longitudinal motion strain, the radial motion strain, the circular motion strain, the rotational motion strain, the longitudinal strain rate and the radial strain rate are recorded, the circumferential strain rate, the rotational strain rate, the total torsional angle peak (ptw), the bottom-bottom horizontal rotation angle peak (Prot-MV), the bottom-bottom horizontal rotation angle, the peak absolute time (Pti-MV), and the peak-to-peak time percentage (Perc-Pti-MV), the apex-level rotation angle peak (Prot-AP), Apex horizontal rotation angle peak absolute time (Pti-AP) and peak time percentage (Perc-Pti-AP). Results: The longitudinal movement strain, the radial movement strain, the circular motion strain, the rotational movement strain, the longitudinal strain rate, the radial strain rate, the circumferential strain rate and the rotational strain rate of the pregnancy and the normal pregnancy group were lower than that of the control group (P0.05). The longitudinal movement strain, the radial movement strain, the circular motion strain, the rotational movement strain, the longitudinal strain rate, the radial strain rate, the circumferential strain rate and the rotational strain rate of the pregnancy and hypertension group were higher than that in the normal pregnancy group (P0.05); and the late-stage longitudinal movement strain and the radial movement strain of the pregnancy and hypertension group, the circular motion strain, the rotational motion strain, the longitudinal strain rate, the radial strain rate, the circumferential strain rate and the rotational strain rate are lower than the middle term (P0.05); and 2, the pregnancy hypertension group is compared with the normal pregnancy group, The peak strain of the myocardium in the 12-segment of the left ventricular segment of the hypertensive group was lower than that in the lower wall, the interventricular septum and the apex.3, Prot-AP, Pti-AP, Perc-Pti-MV, Perc-Pti-AP and Ptw were higher than those in the normal control group (P0.05). The advanced level of Prot-AP in the pregnancy induced hypertension group was higher than that in the normal pregnancy group (P0.05), and the level of Pti-AP and Ptw in the pregnancy-induced hypertension group was higher than that in the normal pregnancy group (P0.05), and the prot-AP and Ptw were higher in the first trimester of pregnancy than in the same group (P0.05). The medium-term level of Pti-Mv in the pregnancy and the normal pregnancy group was lower than that of the normal control group (P0.05), while the medium-term level of the Pti-AP in the pregnancy and the normal pregnancy group was higher than that of the normal control group (P0.05), and the level of the Perc-Pti-AP in the pregnancy and the normal pregnancy group was higher than that in the normal control group (P0.05). The Perc-Pti-MV level was not statistically different between the two groups; Conclusion 1. Compared with the normal pregnant women group, the left ventricular systolic function of the normal pregnant women with LVEF has changed, and the reduction of the contraction function is more obvious with the increase of the gestational period. 2 DSTI has no angular dependence, the repeatability is good, the measurement process is relatively simple, the left ventricular systolic longitudinal, the radial, the circumferential strain and the rotation and the torsion angle can be comprehensively evaluated, so that the whole and the local myocardial function of the left ventricle can be more accurately evaluated.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R714.246
【参考文献】
相关期刊论文 前10条
1 张蕾;张彩云;董珊珊;芦桂林;;二维斑点追踪成像技术评价妊娠期高血压疾病患者左心室心肌应变[J];中华临床医师杂志(电子版);2016年15期
2 马小五;张平洋;张幼祥;董静;;三维斑点追踪显像技术评价健康孕妇分娩前后左心室收缩功能结果分析[J];山东医药;2016年04期
3 雷冬竹;;妊娠中期孕妇血清sFlt-1、PLGF水平及比值变化预测子痫前期发生的价值[J];中国继续医学教育;2015年24期
4 程妤奋;黄鹰;杨慧琳;杨伶俐;邢秋霞;储莉鸣;沈丽华;张宝仁;古航;;PAPP-A、PLGF、sFlt-1预测妊娠期高血压疾病发病风险价值的研究[J];临床和实验医学杂志;2015年03期
5 贾武梅;刘学宁;安雅萍;刘怀荣;崔建均;陈青;;二维超声斑点追踪成像对高血压患者左室纵向收缩和舒张功能的评价[J];宁夏医学杂志;2014年04期
6 王芳;郭凤婵;;PLGF、Flt-1与妊娠期高血压疾病的相关性研究[J];医学综述;2014年04期
7 修金;张玉会;宋艳琴;金影;;二维超声斑点追踪显像评价正常人及冠心病患者的心肌运动[J];中国社区医师(医学专业);2012年31期
8 卢志华;郭瑞强;陈金玲;周青;吴田;;二维超声斑点追踪成像技术评价正常构型原发性高血压患者左心室收缩功能[J];武汉大学学报(医学版);2010年03期
9 朱丽萍;严继萍;;超声二维斑点追踪显像技术在心脏疾病诊断中的临床应用进展[J];实用医学影像杂志;2010年01期
10 谢明星;张丽;吕清;王新房;韩伟;张静;刘莹莹;付倩;项飞翔;;超声二维斑点追踪显像技术评价肥厚型心肌病左心室旋转和扭转运动[J];中国医学科学院学报;2008年01期
相关博士学位论文 前1条
1 巩晓红;超声二维斑点追踪成像技术评价左心室收缩功能的临床研究[D];河北医科大学;2009年
相关硕士学位论文 前1条
1 李成;应用二维超声斑点追踪显像技术评价原发性高血压患者左室长轴收缩功能[D];蚌埠医学院;2012年
，本文编号：2448281
本文链接：https://www.wllwen.com/linchuangyixuelunwen/2448281.html
最近更新
教材专著
