CAJ | 학술논문

目的：应用二维斑点追踪技术(2DSTI)评估房间隔缺损(ASD)患者封堵术后右室功能改变。方法应用2DSTI技术测量52例ASD患者(ASD组)封堵术前、术后1个月右室游离壁基底段、中段、心尖段收缩峰值应变(￡)、收缩峰值应变率(SRs)、舒张早期峰值应变率(SRe)、舒张晚期峰值应变率(SRa)。41例年龄、性别匹配的正常人(正常组)作为对照,测量方法及观察项目同ASD组。结果ASD组患者右室壁各节段的峰值应变及应变率均低于正常组,差异有统计学意义(P<0.05)。随着肺动脉高压(PH)程度的加重, ASD患者基底段、中段、心尖段的￡、SRs、SRe、SRa数值也逐步下降；ASD患者术后1个月与术前比较,各节段的峰值应变及应变率明显增加,差异有统计学意义(P<0.05)。结论ASD患者常合并不同程度的右心室功能减退,肺动脉高压越重,右室功能减退程度越明显, ASD患者封堵术后,其右室功能得到改善,2DSTI技术可准确、客观地评价房间隔缺损患者术后右室功能的变化。
목적：응용이유반점추종기술(2DSTI)평고방간격결손(ASD)환자봉도술후우실공능개변。방법응용2DSTI기술측량52례ASD환자(ASD조)봉도술전、술후1개월우실유리벽기저단、중단、심첨단수축봉치응변(￡)、수축봉치응변솔(SRs)、서장조기봉치응변솔(SRe)、서장만기봉치응변솔(SRa)。41례년령、성별필배적정상인(정상조)작위대조,측량방법급관찰항목동ASD조。결과ASD조환자우실벽각절단적봉치응변급응변솔균저우정상조,차이유통계학의의(P<0.05)。수착폐동맥고압(PH)정도적가중, ASD환자기저단、중단、심첨단적￡、SRs、SRe、SRa수치야축보하강；ASD환자술후1개월여술전비교,각절단적봉치응변급응변솔명현증가,차이유통계학의의(P<0.05)。결론ASD환자상합병불동정도적우심실공능감퇴,폐동맥고압월중,우실공능감퇴정도월명현, ASD환자봉도술후,기우실공능득도개선,2DSTI기술가준학、객관지평개방간격결손환자술후우실공능적변화。
ObjectiveTo apply two-dimensional speckle tracking imaging (2DSTI) in evaluation of right ventricular function change after closure in atrial septal defect (ASD) patients.Methods2DSTI was applied in detection of peak strain shrinkage (￡), systolic peak strain rate (SRs), early diastolic peak strain peak (SRe), and late diastolic peak strain peak (SRa) in right ventricular free wall basal segment, middle segment, and apical segment in 52 ASD patients (ASD group) before closure and in 1 month after operation. There were 41 normal people (normal group) with corresponding age and gender for comparison. Their detection method was the same as the ASD group.ResultsThe ASD group had all lower peak value and strain rate of right ventricle wall in each segment than the normal group, and their difference had statistical significance (P<0.05). The ASD group had gradually decreased ￡, SRs, SRe, and SRa values in basal segment, middle segment, and apical segment, along with the progress of pulmonary hypertension (PH). Comparing with those before operation, the ASD group had obviously increased peak value and strain rate in each segment in 1 month after operation. The difference had statistical significance (P<0.05).ConclusionIt is usual for complicated right ventricular function impairment in ASD patients. Worse pulmonary hypertension will lead to more obvious right ventricular function impairment. Closure in ASD patients can provide remarkable improvement in their right ventricular function. 2DSTI can accurately and objectively evaluate changes of right ventricular function in ASD patients.