CAJ | 학술논문

目的：本研究应用二维斑点追踪成像（2DSTI）技术，比较左室射血分数保留的心力衰竭（HFPEF）患者及无症状的左室舒张功能障碍（LVDD）患者的左室舒张功能及心肌运动同步性，并观察其与血浆 N 末端 B 型钠尿肽前体（NT-pro BNP）之间的相关性。方法实验组 HFPEF 25例，对照组无症状的 LVDD 25例。测量血浆 NT-pro BNP水平；采集左室心尖二腔、三腔、四腔心观动态图像，应用2DSTI 分析测量。结果实验组舒张早期应变率峰值（GLSRe，02-LSRe，03-LSRe，04-LSRe）明显减低（P ＜0．05）；16节段、12节段收缩应变达峰时间的标准差（Ts-SD16、Ts-SD12）增大，任意对应两节段的收缩应变达峰时间的最长时间间隔（Ts-diff）延长（P ＜0．05）。Log NT-pro BNP 与GLSRe，02-LSRe，03-LSRe，04-LSRe、Ts-SD16显著相关（P ＜0．05）。结论2DSTI 能够较为准确地评价舒张功能，区分其受损程度；同时可测定心肌运动的不同步性，为 HFPEF 的诊断和治疗提供新的思路。
목적：본연구응용이유반점추종성상（2DSTI）기술，비교좌실사혈분수보류적심력쇠갈（HFPEF）환자급무증상적좌실서장공능장애（LVDD）환자적좌실서장공능급심기운동동보성，병관찰기여혈장 N 말단 B 형납뇨태전체（NT-pro BNP）지간적상관성。방법실험조 HFPEF 25례，대조조무증상적 LVDD 25례。측량혈장 NT-pro BNP수평；채집좌실심첨이강、삼강、사강심관동태도상，응용2DSTI 분석측량。결과실험조서장조기응변솔봉치（GLSRe，02-LSRe，03-LSRe，04-LSRe）명현감저（P ＜0．05）；16절단、12절단수축응변체봉시간적표준차（Ts-SD16、Ts-SD12）증대，임의대응량절단적수축응변체봉시간적최장시간간격（Ts-diff）연장（P ＜0．05）。Log NT-pro BNP 여GLSRe，02-LSRe，03-LSRe，04-LSRe、Ts-SD16현저상관（P ＜0．05）。결론2DSTI 능구교위준학지평개서장공능，구분기수손정도；동시가측정심기운동적불동보성，위 HFPEF 적진단화치료제공신적사로。
Objective To assess the diastolic function and synchronicity of heart failure with persevered left ventric-ular ejection fraction (HFPEF)patients and asymptomatic with left ventricular diastolic dysfunction (LVDD)patients using two dimensional speckle-tracking imaging(2DSTI)and observe the correlation between the 2DSTI measured indi-cators and plasma NT-pro BNP levels.Methods Patients with HFPEF 25 examples,and a control group of asympto-matic with LVDD 25 examples,determined of the plasma NT- pro BNP level,collected apical four-chamber,three-chamber,two-chamber view dynamic two-dimensional image,analysed by 2DSTI.Results HFPEF patients’global and two-chamber,three-chamber,four-chamber early diastolic strain rate (GLSRe,02-LSRe,03-LSRe,04-LSRe)was signif-icantly lower than the asymptomatic with LVDD group (P <0.05);the value of 16,12 segments’Ts-SD,Ts-diff is big-ger(P <0.05).LogNT-pro BNP and GLSRe,02-LSRe,03-LSRe,04-LSRe,Ts-SD16 were significantly correlated.Con-clusion 2DSTI had higher sensitivity to evaluate the diastolic dysfunction’s degree.it can determine the synchronicity of myocardial activity,provides a new thought of the diagnosis and treatment of HFPEF.