二维斑点追踪技术对缩窄性心包炎患者左心室功能改变的定量评价

发布时间：2019-06-12 11:09

【摘要】：目的采用二维斑点追踪技术对缩窄性心包炎患者左心室功能改变状况进行定量评价。方法 40例缩窄性心包炎患者经临床检测确诊后,行心包剥脱术并常规超声检查,采集患者左室长轴观、二腔、四腔心观和心尖水平、乳头肌、二尖瓣环水平左室短轴观的二维图像,检测各切面最大径向、纵向、圆周以及总体应变,术后1个月后对上述指标重复检测。结果治疗后超声心动图检测结果显示,患者左右心房内径减小,左室内径增加,左心室射血分数提高,舒张早期二尖瓣口速度提升(P0.05);二维斑点追踪技术对手术后患者心尖二腔、四腔切面总体纵向应变进行测量,数据显著提升(P0.05);心尖左室长轴总体纵向应变治疗后在一定程度上增加,但数据比较无统计学意义(P0.05);二尖瓣环、乳头肌以及心尖水平短轴前面总圆周应变测量数据出现显著增加(P0.05);在进行手术后,患者二尖瓣环、心尖水平左室短轴观总体径向应变增加(P0.05),乳头肌水平短轴观总体径向应变略微增加,但差异无统计学意义(P0.05)。结论缩窄性心包炎患者在行心包剥脱术后,机体左室纵向应变、径向应变和圆周应变均存在不同程度改善,能有效恢复患者心脏房室结构,对心功能恢复起到推动作用;同时采用二维斑点追踪技术可以对缩窄性心包炎患者术后恢复效果有效评价,值得推广。
[Abstract]:Objective to quantitatively evaluate the changes of left ventricular function in patients with constrictive pericarditis by two-dimensional speckle tracking technique. Methods after 40 patients with constrictive pericarditis were diagnosed by clinical examination, pericardial stripping and routine ultrasound were performed. The two-dimensional images of left ventricular long axis, two-chamber, four-chamber view and apical level, papillary muscle and mitral annulus were collected to detect the maximum radial, longitudinal, circumferential and overall strain of each section. The above indexes were repeatedly detected one month after operation. Results the results of echocardiography after treatment showed that the left and right atrial diameter decreased, the left ventricular diameter increased, the left ventricular ejection fraction increased, and the mitral valve orifice velocity increased in the early diastolic period (P 0.05). The total longitudinal strain of apical second chamber and four chamber section was measured by two-dimensional spot tracking technique, and the data were significantly improved (P 0.05). The total longitudinal strain of apical left ventricular long axis increased to a certain extent after treatment, but the data were not statistically significant (P 0.05). The total circumferential strain measurement data of mitral annulus, papillary muscle and apical horizontal short axis were significantly increased (P 0.05). After operation, the total radial strain of mitral annulus and apical level left ventricular short axis was increased (P 0.05), and the total radial strain of papillary muscle was slightly increased, but the difference was not statistically significant (P 0.05). Conclusion the longitudinal strain, radial strain and circumferential strain of left ventricle are improved in different degrees in patients with constrictive pericarditis after pericardiectomy, which can effectively restore the atrioventricular structure of patients and promote the recovery of cardiac function. At the same time, two-dimensional spot tracking technique can effectively evaluate the postoperative recovery effect of patients with constrictive pericarditis, which is worth popularizing.
【作者单位】：武汉市第三医院超声影像科;江陵县人民医院影像科;
【分类号】：R445.1;R542.11

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