不同年龄段健康儿童左心室收缩期心肌纵向应变及应变率正常参考值的初步分析

发布时间：2018-03-10 23:06

本文选题：超声心动图　切入点：斑点追踪成像　出处：《第三军医大学学报》2017年17期 　论文类型：期刊论文

【摘要】：目的应用二维斑点追踪成像技术定量分析健康儿童左心室收缩期心肌纵向应变及应变率,并进行其不同年龄段正常参考值的初步分析。方法回顾性分析2015年9月至2016年11月来本院超声科体检的330例健康儿童的超声临床资料。按年龄分成7组,分为新生儿组(0~28 d)、婴儿组(28 d至1岁)、幼儿组(1~3岁)、学龄前期组(3~6岁)、学龄期组(6~9岁)、青春前期组(9~13岁)、青春期组(13~18岁)。采用斑点追踪软件分析左心室心尖3个长轴切面的动态图像,获取左心室收缩期心肌纵向应变及应变率值。结果 (1)6室壁节段间收缩期纵向应变及应变率的差异均有统计学意义(P0.05),且纵向应变及应变率绝对值自基底段向心尖段呈逐渐增加趋势;(2)18节段应变及应变率及整体应变在不同性别间差异均无统计学意义(P0.05);(3)除后壁、下壁、后间隔基底段外,余各室壁节段纵向应变(longitudinal strain,LS)情况为|LS_(新生儿组)||LS_(婴儿组)||LS)(幼儿、学龄前期、学龄期组)||LS_(青春前期、青春期组)|,且整体心肌纵向应变在年龄组间的趋势与其一致;(4)18节段应变与年龄呈正相关,以侧壁心尖段相关性最强(r=0.551,P0.01);与心率均呈负相关,以侧壁中间段相关性最强(r=-0.517,P0.01);整体心肌纵向应变与年龄呈正相关(r=0.665,P0.01),与心率呈负相关(r=-0.625,P0.01)。(5)18节段应变率与年龄、心率的相关性,以及在各年龄组间的差异存在不均一性。结论建立了不同年龄段健康儿童左心室收缩期心肌纵向应变及应变率的正常参考值,并发现其具有自身特征。
[Abstract]:Objective to analyze the longitudinal strain and strain rate of left ventricular systolic myocardium in healthy children by two-dimensional speckle tracing imaging. Methods the ultrasound clinical data of 330 healthy children from September 2015 to November 2016 were analyzed retrospectively and divided into 7 groups according to their age. It was divided into neonatal group (n = 28), infant group (n = 28), infant group (n = 28), young child group (n = 3), age group (n = 6), school age group (n = 69), youth group (n = 9) and adolescent group (n = 13). The dynamic image of the long axis section, The longitudinal strain and strain rate of left ventricular systolic myocardium were obtained. Results there were significant differences in longitudinal strain and strain rate between ventricular wall segments (P 0.05), and the absolute values of longitudinal strain and strain rate were from the basal segment to the apex of the heart. There was no significant difference in strain, strain rate and overall strain between different genders. Apart from the basal segment of the posterior septum, the longitudinal strain of the remaining segments of the ventricular wall is LSSP (newborn group) LSSP (infant group) LSN (infant, pre-school, school-age group) LSs (pre-puberty, pre-adolescence). In puberty group, the trend of global longitudinal strain in age group was consistent with that in age group. The strain of 18 segments was positively correlated with age, especially in the apical segment of lateral wall, and negatively correlated with heart rate, especially in the apical segment of lateral wall. The longitudinal strain of the whole myocardium was positively correlated with age, and negatively correlated with the heart rate, and the strain rate was correlated with age and heart rate in the middle segment of the lateral wall, and there was a negative correlation between the longitudinal strain rate and the age and heart rate in the middle segment of the lateral wall, and there was a negative correlation between the longitudinal strain rate and the heart rate in the middle segment of the lateral wall, and the correlation between the strain rate and the age and heart rate. Conclusion the normal reference values of longitudinal strain and strain rate of left ventricular systolic myocardium in children of different ages were established and their own characteristics were found.
【作者单位】：重庆医科大学附属儿童医院超声科;重庆医科大学附属儿童医院儿童发育疾病研究教育部重点实验室儿童发育重大疾病国家国际科技合作基地儿科学重庆市重点实验室;重庆医科大学附属儿童医院流行病学与生物信息学研究室;重庆医科大学附属儿童医院儿科研究所;
【基金】：国家自然科学基金面上项目(81571688) 重庆市博士后科研项目特别资助项目(Xm2014052) 重庆市基础与前沿研究计划项目(CSTC2014jcyj A10013)~~
【分类号】：R540.45;R725.4

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