CAJ | 학술논문

目的应用二维超声斑点追踪成像技术(2D-STI)评价肝硬化患者左心室局部纵向收缩功能.方法选取34例肝硬化患者为肝硬化组,35名健康志愿者作为正常对照组.常规超声心动图记录左心房及左心室舒张末期前后径、射血分数(EF)、左室短轴缩短率(FS);心尖长轴切面记录二尖瓣舒张期血流频谱E峰及A峰值,并计算E/A值;记录心尖长轴切面、心尖两腔切面及心尖四腔切面的三个完整心动周期的高帧频二维图像,脱机应用二维应变分析软件测量左心室壁各节段收缩期的峰值应变.结果肝硬化组左心房收缩期前后径(30.49 mm±4.20 mm)、左心室舒张末期前后径(44.90 mm±4.33 mm)与正常对照组(28.82 mm±3.67 mm,43.25 mm±3.21 mm)比较差异无统计学意义(P>0.05).肝硬化组EF(61.15%±4.41%)及FS(32.92%±3.34%)与正常对照组(59.74%±5.45%,32.05%±3.71%)比较差异无统计学意义(P>0.05).肝硬化组E/A值(1.03±0.29)较正常对照组(1.31±2.74)减低,差异有统计学意义(P<0.05).肝硬化组左心室各节段收缩期纵向峰值应变均低于正常对照组,除左心室后壁基底段、前壁基底段、下壁基底段、前间隔基底段及后间隔中间段和基底段外,其他各节段间差异均有统计学意义(P<0.05).结论肝硬化患者左心室形态、舒张功能及左心室局部纵向收缩功能均存在异常,2D-STI较常规超声检查可以较早地、敏感地反映肝硬化患者左心室局部纵向收缩功能改变.
목적 응용이유초성반점추종성상기술(2D-STI)평개간경화환자좌심실국부종향수축공능.방법 선취34례간경화환자위간경화조,35명건강지원자작위정상대조조.상규초성심동도기록좌심방급좌심실서장말기전후경、사혈분수(EF)、좌실단축축단솔(FS);심첨장축절면기록이첨판서장기혈류빈보E봉급A봉치,병계산E/A치;기록심첨장축절면、심첨량강절면급심첨사강절면적삼개완정심동주기적고정빈이유도상,탈궤응용이유응변분석연건측량좌심실벽각절단수축기적봉치응변.결과 간경화조좌심방수축기전후경(30.49 mm±4.20 mm)、좌심실서장말기전후경(44.90 mm±4.33 mm)여정상대조조(28.82 mm±3.67 mm,43.25 mm±3.21 mm)비교차이무통계학의의(P>0.05).간경화조EF(61.15%±4.41%)급FS(32.92%±3.34%)여정상대조조(59.74%±5.45%,32.05%±3.71%)비교차이무통계학의의(P>0.05).간경화조E/A치(1.03±0.29)교정상대조조(1.31±2.74)감저,차이유통계학의의(P<0.05).간경화조좌심실각절단수축기종향봉치응변균저우정상대조조,제좌심실후벽기저단、전벽기저단、하벽기저단、전간격기저단급후간격중간단화기저단외,기타각절단간차이균유통계학의의(P<0.05).결론 간경화환자좌심실형태、서장공능급좌심실국부종향수축공능균존재이상,2D-STI교상규초성검사가이교조지、민감지반영간경화환자좌심실국부종향수축공능개변.
Objective To assess the left ventricular longitudinal shrinkage function in liver cirrhosis patients with two-dimensional speckle tracking imaging (2D-STI). Methods Echocardiography and Doppler echocardiography were performed in 34 patients with liver cirrhosis and 35 healthy subjects of corresponding ages. High frame rate two-dimensional images were recorded from apical long-axis view, four-chamber view and two-chamber view of left ventricle; then the left ventricular diameter, left atrium diameter, the peak filling velocity of E wave and A wave, E/A ratio, EF and FS were measured. The peak systolic strain of left ventricular segment was measured with two-dimensional strain software. Results Compared with healthy subjects, left ventricular diameter, left atrium diameter, EF and FS of liver cirrhosis patients were not statistically different (P>0.05), but the E/A ratio was lower (P<0.05). The peak systolic strain of most left ventricular segment in liver cirrhosis reduced significantly (P<0.05), except that of base segment of posterior wall, anterior wall, inferior wall, anterior and posterior interventricular septum, as well as middle segment of posterior interventricular septum. Conclusion The heart shape, systolic and diastole function of liver cirrhosis are abnormal. 2D-STI can early and accurately evaluate the systolic function of liver cirrhosis.