左室心肌致密化不全与肥厚型心肌病的超声心动图比较

发布时间：2018-03-16 14:39

本文选题：左室心肌致密化不全　切入点：肥厚型心肌病　出处：《临床心血管病杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的:探讨左室心肌致密化不全(LVNC)和肥厚型心肌病(HCM)相关超声心动图的参数,分析比较二者整体及局部心功能的差别。方法:分析2015-01-2017-01在郑州大学第一附属医院诊断为LVNC的患者30例(LVNC组)、HCM患者30例(HCM组)。通过常规超声心动图分析比较两组患者的肌小梁数目、最大室壁厚度(MWT)、左室射血分数(LVEF)。通过二维斑点追踪成像技术(two-dimensional speckle tracking imaging,2D-STI)比较2组患者左心整体纵向应变性(global longitudinal strain,GLs)及左室基底部和心尖部的节段纵向应变性(section longitudinal strains,SLs)。结果:(1)与HCM组相比,LVNC组肌小梁数目显著增加[(8.47±3.54)个∶(1.20±1.67)个,P0.01]、MWT显著减小[(9.97±1.88)mm∶(18.04±2.15)mm,P0.01]、LVEF显著减低[(41.77±8.07)%∶(55.87±4.11)%,P0.01],但2组患者左心GLs无统计学差异[(-14.04±2.59)%∶(-15.30±2.67)%,P=0.069]。(2)HCM组基底部至心尖部SLs显著增加[(-13.29±2.68)%∶(-19.17±2.72)%,P0.001)],但LVNC组基底部和心尖部SLs无统计学差异[(-13.07±2.56)%∶(-14.26±2.55)%,P=0.075]。结论:LVNC一般伴随着肌小梁数目的增加、MWT变薄、LVEF降低,并且基底部-心尖部心功能梯度消失,但HCM基底部心功能减低更为明显,且基底部至心尖部心功能存在一定梯度。上述特征有助于LVNC和HCM的鉴别。
[Abstract]:Objective: to study the parameters of left ventricular myocardial densification associated with LVNCand HCM in patients with hypertrophic cardiomyopathy. Methods: 30 patients diagnosed as LVNC in the first affiliated Hospital of Zhengzhou University from January 2015-2011 to January 2017-01 were analyzed and compared by routine echocardiography. The number of trabeculae, Maximum wall thickness and left ventricular ejection fraction (LVEF). Two-dimensional speckle tracking imaging (2D-STI) was used to compare the global longitudinal anisotropy of the left ventricular (LVG) and the segment of left ventricular base and apical segments in the two groups. Compared with HCM group, the number of trabeculae increased significantly [8.47 卤3.54) 1.20 卤1.67] MWT significantly decreased [9.97 卤1.88 mm: 18.04 卤2.15 mm P0.01] and significantly decreased [41.77 卤8.07 卤5.87 卤4.11 P0.01], but there was no significant difference in left heart GLs between the two groups [-14.04 卤2.59% -15.30 卤2.67 P0.069] .2HCM group increased significantly SLs from the base to the heart [13.-29 卤2.68 卤2.72P1], but there was no statistical difference between the LVNC group and the bottom of the heart group (P 0.069), but there was no statistical difference between the two groups in the GLs of the left heart [-14.04 卤2.59] -15.30 卤2.67% P0.069] .2the number of SLs in the base of the LVNC group increased significantly [13.-29 卤2.68 卤2.72P1], but there was no statistical difference between the two groups in the GLs of the left heart [-14.04 卤2.59] -15.30 卤2.67p0.069]. There was no significant difference in SLs in the tip [-13.07 卤2.56: -14.26 卤2.555.Conclusion: the increase of the number of muscle trabeculae is associated with the decrease of the number of muscle trabeculae. The cardiac function gradient from the base to the apex disappeared, but the decrease of the cardiac function at the base of HCM was more obvious, and there was a gradient between the base and the apex of the cardiac function. The above characteristics are helpful for the differential diagnosis of LVNC and HCM.
【作者单位】：郑州大学第一附属医院心血管内科;郑州大学人民医院心血管内科;临沂大学药学院;郑州大学第一附属医院超声科;
【分类号】：R542.2

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