CAJ | 학술논문

目的应用组织多普勒成像技术了解健康儿童左、右心室功能随年龄增长的变化特点及相互关系.方法收集2013年11月至2014年2月在中山大学附属第一医院参与检查研究的0 ～15岁健康儿童,按年龄段分为6组,婴儿期组(0～1岁)、幼儿期组(＞1～3岁)、学龄前期组(＞3 ～6岁)、学龄期组(＞6 ～9岁)、青春前期组(＞9～ 12岁)、青春期组(＞12 ～ 15岁);并征集健康青少年(＞15～25岁)作为青少年组.每组收集15～ 30例志愿者.研究对象均行超声心动图检查,包括心脏腔径测量;频谱多普勒测量舒张早期血流速度(E)/舒张晚期血流速度(A)比值;组织多普勒测量房室瓣环处组织运动速度与时间参数,收缩期组织运动速度(s)、舒张早期组织运动速度(e)及舒张晚期组织运动速度(a)、等容收缩期、射血期、等容舒张期,计算等容收缩期加速度(ⅣA)与Tei指数.比较各组间所得数据,探讨与年龄增长的关系及相关因素,并进一步比较左、右心室功能指标关系.结果左心室Tei指数与等容收缩期在青春期显著减低;血流E/A比值与e/a比值自婴儿期至学龄前期随年龄增长逐渐增大,之后各年龄组间差异无统计学意义(P＞0.05).右心室Tei指数、ⅣA、E/A、e/a各年龄组间差异无统计学意义(P＞0.05).左心室s、ⅣA显著小于右心室(P均＜0.001),而E/e、e/a显著高于右心室(P均＜0.001).结论健康儿童左心室收缩功能在青春期增强,舒张功能自婴儿期至学龄前期逐渐增强,之后维持稳定.右心室收缩、舒张功能随年龄增长无明显变化.左心室舒张功能强于右心室,右心室纵向收缩功能强于左心室.
목적 응용조직다보륵성상기술료해건강인동좌、우심실공능수년령증장적변화특점급상호관계.방법 수집2013년11월지2014년2월재중산대학부속제일의원삼여검사연구적0 ～15세건강인동,안년령단분위6조,영인기조(0～1세)、유인기조(＞1～3세)、학령전기조(＞3 ～6세)、학령기조(＞6 ～9세)、청춘전기조(＞9～ 12세)、청춘기조(＞12 ～ 15세);병정집건강청소년(＞15～25세)작위청소년조.매조수집15～ 30례지원자.연구대상균행초성심동도검사,포괄심장강경측량;빈보다보륵측량서장조기혈류속도(E)/서장만기혈류속도(A)비치;조직다보륵측량방실판배처조직운동속도여시간삼수,수축기조직운동속도(s)、서장조기조직운동속도(e)급서장만기조직운동속도(a)、등용수축기、사혈기、등용서장기,계산등용수축기가속도(ⅣA)여Tei지수.비교각조간소득수거,탐토여년령증장적관계급상관인소,병진일보비교좌、우심실공능지표관계.결과 좌심실Tei지수여등용수축기재청춘기현저감저;혈류E/A비치여e/a비치자영인기지학령전기수년령증장축점증대,지후각년령조간차이무통계학의의(P＞0.05).우심실Tei지수、ⅣA、E/A、e/a각년령조간차이무통계학의의(P＞0.05).좌심실s、ⅣA현저소우우심실(P균＜0.001),이E/e、e/a현저고우우심실(P균＜0.001).결론 건강인동좌심실수축공능재청춘기증강,서장공능자영인기지학령전기축점증강,지후유지은정.우심실수축、서장공능수년령증장무명현변화.좌심실서장공능강우우심실,우심실종향수축공능강우좌심실.
Objective To explore the development and interaction of left and right ventricular function in healthy children using tissue Doppler imaging.Methods Healthy children aged 0-15 years and adolescents were recruited,then children were divided into 6 groups:0-1 year,＞ 1-3 years,＞ 3-6 years,＞ 6-9 years,＞ 9-12 years,＞ 12-15 years.Healthy adolescents aged ＞ 15-25 years were also recruited.Every subject underwent echocardiography including cardiac dimension measurements,atrio-ventricular valvular velocity and early-diastolic flow velocity(E)/late-diastolic flow evlocity(A) ratio measured by pulsed color Doppler,atrio-ventricular annular myocardial velocity (including systolic velocity (s),early diastolic velocity (e) and late diastolic velocity (a)),time intervals (including isovolumic contraction time,ejection time and isovolumic relaxation time),isovolumic acceleration (ⅣA) and Tei index measured by tissue Doppler imaging.Results were compared among different groups,the correlations with age and other factors were explored.Furthermore,comparison was done between left and right ventricular functional parameters.Results Left ventricular Tei index and isovolumic contraction time were significantly lower during puberty.From infancy to pre-school stage,left ventricular E/A (flow velocity) and e/a(tissue velocity) increased accordingly,then presented with no significant changes among the following age groups(P ＞ 0.05).There were no significant differences in right ventricular Tei index,ⅣA,E/A (flow velocity) and e/a (tissue velocity) among the 6 groups (P ＞ 0.05).Left ventricular systolic myocardial velocity (s) and ⅣA were significantly lower than right ventricle (all P ＜ 0.001).However,left ventricular E/e(flow velocity) and e/a(tissue velocity) were significantly greater than right ventricle (all P ＜0.001).Conclusions In healthy children,left ventricular systolic function enhances during puberty,diastolic function increases from infancy to pre-school stage,then keeps stable till adolescents.Right ventricular systolic and diastolic function present with no significant changes during growth.Left ventricular diastolic function is greater than right one,however,right ventricular longitudinal systolic function is greater than left one.