CAJ | 학술논문

目的采用二维斑点追踪成像及组织多普勒技术观察房间隔缺损患者修补术前后右室整体及局部功能的变化.方法选取继发孔型房间隔缺损患者30例,分别于术前(A组)及术后1月(B组)行常规经胸超声心动图检查,采用二维斑点追踪成像技术分别测定右室游离壁及室间隔各节段的应变和应变率,并通过组织多普勒技术测定右室Tei指数,另设30例正常人对照组(C组).结果术前组右心室游离壁基底段、中间段及心尖段的应变和应变率均高于正常对照组相同节段(P＜0.05);而室间隔各节段的应变和应变率与正常组比较差异无统计学意义(P＞0.05);术前组Tei指数(0.24±0.06)较正常组(0.41 ±0.05)减低(P＜0.05).术后组右心室游离壁基底段、中间段及心尖段的最大应变和应变率均较术前减低(P＜0.05),但仍高于正常对照组;室间隔基底段的应变较术前及正常组均减低(P＜0.05),而室间隔基底段的应变率、室间隔中间段及心尖段的应变及应变率与术前及正常组比较差异均无统计学意义(P＞0.05).与术前组比较,术后组Tei指数升高至0.34 ±0.05(P ＜0.05),但仍低于正常组(P＜0.05).结论房间隔缺损修补术后,右心负荷降低,右室的整体与局部功能均有不同程度改善,右室Tei指数、右室壁应变及应变率能无创、准确的反映右室功能的变化.
목적 채용이유반점추종성상급조직다보륵기술관찰방간격결손환자수보술전후우실정체급국부공능적변화.방법 선취계발공형방간격결손환자30례,분별우술전(A조)급술후1월(B조)행상규경흉초성심동도검사,채용이유반점추종성상기술분별측정우실유리벽급실간격각절단적응변화응변솔,병통과조직다보륵기술측정우실Tei지수,령설30례정상인대조조(C조).결과 술전조우심실유리벽기저단、중간단급심첨단적응변화응변솔균고우정상대조조상동절단(P＜0.05);이실간격각절단적응변화응변솔여정상조비교차이무통계학의의(P＞0.05);술전조Tei지수(0.24±0.06)교정상조(0.41 ±0.05)감저(P＜0.05).술후조우심실유리벽기저단、중간단급심첨단적최대응변화응변솔균교술전감저(P＜0.05),단잉고우정상대조조;실간격기저단적응변교술전급정상조균감저(P＜0.05),이실간격기저단적응변솔、실간격중간단급심첨단적응변급응변솔여술전급정상조비교차이균무통계학의의(P＞0.05).여술전조비교,술후조Tei지수승고지0.34 ±0.05(P ＜0.05),단잉저우정상조(P＜0.05).결론 방간격결손수보술후,우심부하강저,우실적정체여국부공능균유불동정도개선,우실Tei지수、우실벽응변급응변솔능무창、준학적반영우실공능적변화.
Objective To evaluate the global and regional function of the right ventricular in patients with atrial septal defects (ASD) by two dimensional speckle tracking imaging (2D-STI) and tissue Doppler image (TDI)before and after surgical repair.Methods Thirty patients with atrial septal defects were enrolled and divided into two groups:before the surgical repair (group A) and after the surgical repair (group B).All of them underwent thoracic echocardiographic examination.The Tei index was obtained by tissue Doppler image,and the strains and strain rates of the right ventricular free wall and the ventricular septum were obtained by two dimensional speckle tracking imaging.Meanwhile,thirty normal volunteers were chosen as controls (group C).Results Compared with group C,the strains and strain rates in the basal,middle,and apical segments of the right ventricular free wall were significantly higher in group A (All P ＜ 0.05) ; the strains and strain rates in the basal,middle,and apical segment of the ventricular septum were no difference between the two groups (All P ＞ 0.05) ; And the Tei index was lower in group A (0.24±0.06) than in group C (0.41 ±0.05) (P＜0.05).As to the comparison to group A,the strains and strain rates in the basal,middle,apical segment of the right ventricular free wall in group B were all decreased (All P ＜ 0.05),but still higher than group C (All P ＜ 0.05),the maximum strains and strain rates in the middle and apical segments of the ventricular septum in this three groups were no significant difference (All P ＞ 0.05),the strain in the basal segment of the ventricular septum was decreased in group B (P ＜ 0.05).In group B,the Tei index was increased into 0.34 ± 0.05 comparing with group A (P ＜ 0.05),but still lower than in group C (P ＜ 0.05).Conclusion The global and regional function of the right ventricular change significantly after the surgical repair of the atrial septal defects.The Tei index of the right ventricular and the strain and strain rate can estimate the right ventricular function accurately、non-invasively.