左心室纵向应变评估川崎病急性期患儿心肌损伤的相关研究
发布时间：2018-07-21 14:46
【摘要】：目的通过二维斑点追踪技术获取左室心肌纵向应变,探讨其对儿童川崎病急性期心肌损伤的诊断及预测价值。方法 60例KD急性期患者根据有无冠状动脉扩张(CAE)分为无冠脉损伤组(B组)和冠脉损伤组(C组);选择56例健康体检儿童作为对照组(A组),采集研究对象心肌动态图像,行二维超声心动图检查,记录心尖位左四腔观、二腔观及长轴观图像,使用Simpon法进行左室射血分数(LVEF)测量。应用QLA10.0软件对所采集的心肌图像进行斑点追踪并获得左室二腔心(AP2LS)、三腔心(AP3LS)、四腔心(AP4LS)纵向应变值及左室整体纵向应变值(GLS),分析心肌运动情况。分别计算AP2LS、AP3LS、AP4LS及GLS判断CAE的ROC曲线下面积(AUC),获得鉴别CAE的最佳临界值。结果 (1)常规超声指标LVEF差异无统计学意义。(2)3组间及组间AP2LS、AP3LS、AP4LS及GLS比较差异均有统计学意义(P0.01)(3)AP2LS、AP3LS、AP4LS、GLS诊断CAE的AUC分别为0.68(95%CI:0.53~0.83),0.86(95%CI:0.74~0.98),0.82(95%CI:0.71~0.93),0.94(95%CI:0.88~1.00)。以AP2LS诊断CAE的AUC为对照,AP3LS、GLS与其比较差异有统计学意义(P0.05)。ROC曲线显示GLS诊断CAE的敏感度为94%、特异度为90%,AP3LS诊断CAE的敏感度及特异度分别为74%和90%。结论二维斑点追踪成像左室心肌纵向应变技术可早期评估川崎病患儿心肌的受损情况。
[Abstract]:Objective to study the diagnostic and predictive value of left ventricular longitudinal strain in children with Kawasaki disease (Kawasaki disease). Methods Sixty patients with KD were divided into two groups according to coronary artery dilatation (CAE): no coronary artery injury group (group B) and coronary artery injury group (group C), 56 healthy children were selected as control group (group A), and myocardial dynamic images were collected. Left four-chamber view, two-chamber view and long-axis view were recorded by two-dimensional echocardiography. Left ventricular ejection fraction (LVEF) was measured by Simpon method. The left ventricular two-chamber heart (AP2LS), three-chamber heart (AP3LS), four-chamber heart (AP4LS) longitudinal strain and left ventricular global longitudinal strain (GLS) were obtained by using QLA10.0 software. The area under the ROC curve (AUC) of CAE was calculated by AP2LSU AP3LSU AP4LS and GLS, and the best critical value for CAE identification was obtained. Results (1) there was no significant difference in LVEF between three groups and among groups (P0.01) (P0.01). (3) the AUC of AP2LSU AP4LSLS in the diagnosis of CAE was 0.68 (95CI0.530.83) 0.86 (95CI0.740.98) 0.82 (95CI0.710.93) 0.94 (95CI0.881.00). Compared with AUC of CAE diagnosed by AP2LS, there was significant difference between GLS and GLS (P0.05) .ROC curve showed that the sensitivity of GLS in the diagnosis of CAE was 94%, the specificity was 90% and the sensitivity and specificity of GLS in the diagnosis of CAE were 74% and 90%, respectively. Conclusion the two-dimensional dot-tracing imaging left ventricular longitudinal strain technique can be used to evaluate myocardial damage in children with Kawasaki disease.
【作者单位】： 苏州大学附属第三医院常州市第一人民医院心功能科;苏州大学附属第三医院常州市第一人民医院儿科;苏州大学附属第三医院常州市第一人民医院心内科;
【基金】：常州市科技局应用基础研究CJ20160030 常州市卫计委重大课题ZD201407
【分类号】：R725.4
，
本文编号：2135867
[Abstract]:Objective to study the diagnostic and predictive value of left ventricular longitudinal strain in children with Kawasaki disease (Kawasaki disease). Methods Sixty patients with KD were divided into two groups according to coronary artery dilatation (CAE): no coronary artery injury group (group B) and coronary artery injury group (group C), 56 healthy children were selected as control group (group A), and myocardial dynamic images were collected. Left four-chamber view, two-chamber view and long-axis view were recorded by two-dimensional echocardiography. Left ventricular ejection fraction (LVEF) was measured by Simpon method. The left ventricular two-chamber heart (AP2LS), three-chamber heart (AP3LS), four-chamber heart (AP4LS) longitudinal strain and left ventricular global longitudinal strain (GLS) were obtained by using QLA10.0 software. The area under the ROC curve (AUC) of CAE was calculated by AP2LSU AP3LSU AP4LS and GLS, and the best critical value for CAE identification was obtained. Results (1) there was no significant difference in LVEF between three groups and among groups (P0.01) (P0.01). (3) the AUC of AP2LSU AP4LSLS in the diagnosis of CAE was 0.68 (95CI0.530.83) 0.86 (95CI0.740.98) 0.82 (95CI0.710.93) 0.94 (95CI0.881.00). Compared with AUC of CAE diagnosed by AP2LS, there was significant difference between GLS and GLS (P0.05) .ROC curve showed that the sensitivity of GLS in the diagnosis of CAE was 94%, the specificity was 90% and the sensitivity and specificity of GLS in the diagnosis of CAE were 74% and 90%, respectively. Conclusion the two-dimensional dot-tracing imaging left ventricular longitudinal strain technique can be used to evaluate myocardial damage in children with Kawasaki disease.
【作者单位】： 苏州大学附属第三医院常州市第一人民医院心功能科;苏州大学附属第三医院常州市第一人民医院儿科;苏州大学附属第三医院常州市第一人民医院心内科;
【基金】：常州市科技局应用基础研究CJ20160030 常州市卫计委重大课题ZD201407
【分类号】：R725.4
，
本文编号：2135867
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