中华医学超声杂志（电子版）
中華醫學超聲雜誌（電子版）
중화의학초성잡지（전자판）
CHINESE JOURNAL OF MEDICAL ULTRASOUND(ELECTRONICAL VISION)
2013年
9期
31-35
,共5页
王晨阳%黎春雷%刘红云%金丹%邓又斌
王晨暘%黎春雷%劉紅雲%金丹%鄧又斌
왕신양%려춘뢰%류홍운%금단%산우빈
超声心动描记术,多普勒%主动脉瓣关闭不全%心室功能,左
超聲心動描記術,多普勒%主動脈瓣關閉不全%心室功能,左
초성심동묘기술,다보륵%주동맥판관폐불전%심실공능,좌
Echocardiography,Doppler%Aortic valve insufficiency%Ventricular function,left
目的探讨主动脉瓣反流（AR）患者左心室纵向及径向应变的改变，同时研究二维应变与左心室充盈及射血的关系。方法选取AR患者45例（中度24例，重度21例），健康对照者30例。采用二维斑点追踪技术测量并计算左心室收缩期径向峰值总应变(GRS)、收缩期纵向峰值总应变（GLS）及各节段收缩期纵向峰值应变（S）、收缩期纵向峰值应变率（SRs）、舒张早期纵向峰值应变率（SRe）。常规多普勒测量二尖瓣口血流频谱舒张早期及晚期峰值速度E、A，计算E/A，组织多普勒测量二尖瓣环舒张早期速度Ea，计算E/Ea。采用Pearson相关分析方法分析AR患者GLS与左心室射血分数（LVEF）及E/Ea的相关性。结果健康对照组、中度AR组、重度AR组受检者GLS分别为（-20.09±1.47）%、（-18.68±1.52）%、（-12.56±3.25）%，GRS分别为（46.71±7.65）%、（43.01±5.95）%、（28.52±6.13）%，差异均有统计学意义（F=82.08、47.69，P均＜0.01）；重度AR组GLS和GRS与健康对照组及中度AR组比较，差异均有统计学意义（q=17.56、13.60和13.44、10.20，P均＜0.01），中度AR组GLS与健康对照组比较，差异亦有统计学意义（q=3.42，P＜0.01）。3组受检者心尖段SRs分别为（-1.24±0.22）s-1、（-1.19±0.25）s-1、（-1.04±0.28）s-1，差异有统计学意义（F=4.47，P＜0.01）；重度AR组与健康对照组及中度AR组比较，差异均有统计学意义（q=4.02、3.28，P均＜0.01）。中度AR患者心尖段S、SRe，基底段和中间段S、SRs、SRe均低于健康对照者（q=4.42、5.01、3.48、3.24、4.78、4.12、3.61、6.72，P均＜0.01）。Pearson相关分析表明AR患者GLS与LVEF及E/Ea均有相关性（r=-0.73、0.64，P均＜0.01）。结论二维斑点追踪技术测得的AR患者左心室纵向应变及应变率的减低能早期识别左心室功能的受损，且GLS能反映左心室舒张期的充盈及收缩期的射血能力。
目的探討主動脈瓣反流（AR）患者左心室縱嚮及徑嚮應變的改變，同時研究二維應變與左心室充盈及射血的關繫。方法選取AR患者45例（中度24例，重度21例），健康對照者30例。採用二維斑點追蹤技術測量併計算左心室收縮期徑嚮峰值總應變(GRS)、收縮期縱嚮峰值總應變（GLS）及各節段收縮期縱嚮峰值應變（S）、收縮期縱嚮峰值應變率（SRs）、舒張早期縱嚮峰值應變率（SRe）。常規多普勒測量二尖瓣口血流頻譜舒張早期及晚期峰值速度E、A，計算E/A，組織多普勒測量二尖瓣環舒張早期速度Ea，計算E/Ea。採用Pearson相關分析方法分析AR患者GLS與左心室射血分數（LVEF）及E/Ea的相關性。結果健康對照組、中度AR組、重度AR組受檢者GLS分彆為（-20.09±1.47）%、（-18.68±1.52）%、（-12.56±3.25）%，GRS分彆為（46.71±7.65）%、（43.01±5.95）%、（28.52±6.13）%，差異均有統計學意義（F=82.08、47.69，P均＜0.01）；重度AR組GLS和GRS與健康對照組及中度AR組比較，差異均有統計學意義（q=17.56、13.60和13.44、10.20，P均＜0.01），中度AR組GLS與健康對照組比較，差異亦有統計學意義（q=3.42，P＜0.01）。3組受檢者心尖段SRs分彆為（-1.24±0.22）s-1、（-1.19±0.25）s-1、（-1.04±0.28）s-1，差異有統計學意義（F=4.47，P＜0.01）；重度AR組與健康對照組及中度AR組比較，差異均有統計學意義（q=4.02、3.28，P均＜0.01）。中度AR患者心尖段S、SRe，基底段和中間段S、SRs、SRe均低于健康對照者（q=4.42、5.01、3.48、3.24、4.78、4.12、3.61、6.72，P均＜0.01）。Pearson相關分析錶明AR患者GLS與LVEF及E/Ea均有相關性（r=-0.73、0.64，P均＜0.01）。結論二維斑點追蹤技術測得的AR患者左心室縱嚮應變及應變率的減低能早期識彆左心室功能的受損，且GLS能反映左心室舒張期的充盈及收縮期的射血能力。
목적탐토주동맥판반류（AR）환자좌심실종향급경향응변적개변，동시연구이유응변여좌심실충영급사혈적관계。방법선취AR환자45례（중도24례，중도21례），건강대조자30례。채용이유반점추종기술측량병계산좌심실수축기경향봉치총응변(GRS)、수축기종향봉치총응변（GLS）급각절단수축기종향봉치응변（S）、수축기종향봉치응변솔（SRs）、서장조기종향봉치응변솔（SRe）。상규다보륵측량이첨판구혈류빈보서장조기급만기봉치속도E、A，계산E/A，조직다보륵측량이첨판배서장조기속도Ea，계산E/Ea。채용Pearson상관분석방법분석AR환자GLS여좌심실사혈분수（LVEF）급E/Ea적상관성。결과건강대조조、중도AR조、중도AR조수검자GLS분별위（-20.09±1.47）%、（-18.68±1.52）%、（-12.56±3.25）%，GRS분별위（46.71±7.65）%、（43.01±5.95）%、（28.52±6.13）%，차이균유통계학의의（F=82.08、47.69，P균＜0.01）；중도AR조GLS화GRS여건강대조조급중도AR조비교，차이균유통계학의의（q=17.56、13.60화13.44、10.20，P균＜0.01），중도AR조GLS여건강대조조비교，차이역유통계학의의（q=3.42，P＜0.01）。3조수검자심첨단SRs분별위（-1.24±0.22）s-1、（-1.19±0.25）s-1、（-1.04±0.28）s-1，차이유통계학의의（F=4.47，P＜0.01）；중도AR조여건강대조조급중도AR조비교，차이균유통계학의의（q=4.02、3.28，P균＜0.01）。중도AR환자심첨단S、SRe，기저단화중간단S、SRs、SRe균저우건강대조자（q=4.42、5.01、3.48、3.24、4.78、4.12、3.61、6.72，P균＜0.01）。Pearson상관분석표명AR환자GLS여LVEF급E/Ea균유상관성（r=-0.73、0.64，P균＜0.01）。결론이유반점추종기술측득적AR환자좌심실종향응변급응변솔적감저능조기식별좌심실공능적수손，차GLS능반영좌심실서장기적충영급수축기적사혈능력。
Objective Analyse the change of left ventricular (LV) longitudinal and radial strain in patients with aortic regurgitation (AR) and discuss the relationship between the 2D strain parameter and the filling and ejection of LV. Methods Thirty healthy controls and 45 patients with AR (24 patients with moderate AR and 21 with severe AR) were enrolled in this study, LV systolic global peak radial strain(GRS), systolic global peak longitudinal strain(GLS) and systolic peak longitudinal strain(S), systolic peak longitudinal strain rate(SRs), early diastolic peak longitudinal strain rate(SRe) of every segment were measured or calculated using 2D-STE, early and late diastolic transmitral flow velocity (E, A) were recorded by pulsed Doppler echocardiography and early diastolic mitral annular velocity (Ea) were assessed by tissue Doppler imaging,the E/A and E/Ea ratio were calculated. Discuss the relationship of GLS and LV ejection fraction (LVEF), GLS and E/Ea using the Pearson correlation analysis. Results The GLS were (-20.09±1.47)%, (-18.68±1.52)%, (-12.56±3.25)%and the GRS were (46.71±7.65)%, (43.01±5.95)%, (28.52±6.13)% in control group, patients with moderate and severe AR (MAR group and SAR group) respectively. There were significant differences among the groups (F =82.08,47.69, both P < 0.01) as following:SAR group with control group and MAR group [ q=17.56,13.60 (GLS), q=13.44, 10.20 (GRS), all P<0.01),MAR group and control group [ q=3.42 (GLS), P<0.01]. The SRs of the apical segment were (-1.24±0.22)s-1, (-1.19±0.25)s-1, (-1.04±0.28)s-1 in control group,MAR group and SAR group respectively. There were significant differences among the groups (F=4.47, P < 0.05) as following:SAR group with control group and MAR group ( q=4.02,3.28, both P<0.01). The S, SRe of apical segment and the S,SRs,SRe of basal and midventricular in MAR group were all lower than the control group ( q=4.42, 5.01, 3.48, 3.24, 4.78, 4.12, 3.61, 6.72, all P < 0.01). Pearson correlation analysis revealed the GLS had a relationship with LVEF and E/Ea ( r=-0.73, 0.64, both P<0.01). Conclusion The reduced longitudinal strain and strain rate could detect LV dysfunction in patients with AR in early stage and the GLS had the ability to reflect the diastolic filling and systolic ejecting of the LV.
