斑点追踪显像技术评价缺血性心肌病和扩张型心肌病患者左心房功能  

Evaluation of the Left Atrial Function in Ischemic Cardiomyopathy and Dilated Cardiomyopathy Patients by Speckle Tracking Imaging

作　　者：尹家保[1] 谢满英[1] 解芸竹[1] 周素芬[1] 安鹏[1] 

机构地区：[1]湖北医药学院附属襄阳医院超声影像科,湖北襄阳441000

出　　处：《湖北医药学院学报》2012年第4期301-305,封3,共6页Journal of Hubei University of Medicine

摘　　要：目的:探讨斑点追踪显像技术(STI)定量评价缺血性心肌病(ICM)和扩张型心肌病(DCM)患者左心房功能,并作对比研究。方法:选择ICM患者32例、DCM患者36例和健康对照组31例,采用双平面法测量左心房最大容积(LAVmax)、最小容积(LAVmin)、收缩前容积(LAVp),并计算左心房总的射血分数(LATEF)、被动射血分数(LAPEF)、主动射血分数(LAAEF)。运用STI测量左心房房间隔、侧壁、前壁、下壁和后壁的收缩期应变和应变率(Ss和SRs),舒张早期应变和应变率(Se和SRe),舒张晚期应变和应变率(Sa和SRa)。计算出所有房壁的平均应变(mSs、mSe和mSa)及应变率(mSRs、mSRe和mSRa),并分析左心房射血分数与平均应变率之间的相关性。结果:⑴3组受检者在年龄、性别、心率、室间隔厚度(IVS)、E峰等指标差异无统计学意义。ICM组和DCM组A峰、左心室射血分数(LVEF)较对照组减小,左心房前后径(LAD)、左心室舒张末期内径(LVEDD)、E/A等较对照组增大(P<0.05),而ICM组和DCM组之间差异无统计学意义。⑵与对照组相比,ICM组和DCM组LAVmax、LAVmin增大,而LATEF、LAPEF和LAAEF则降低,差异有统计学意义(P<0.05);与ICM组相比,DCM组LATEF、LAAEF更低(P<0.05)。⑶与对照组相比,ICM组和DCM组mSs、mSRs、mSe、mSRe、mSa和mSRa均降低(P<0.05),且DCM组降低更显著(P<0.05)。⑷LATEF与mSRs呈较好的正相关(r=0.66,P<0.05),LAPEF与|mSRe|具有较强的相关性(r=0.71,P<0.01),LAAEF与|mSRa|相关性较好(r=0.69,P<0.01)。结论:ICM和DCM患者左心房动态储血功能和主动射血功能均降低,且DCM较ICM患者降低更明显。斑点追踪显像技术能较好地评价左心房功能。Objective To evaluate the left atrial function and make a comparison analysis in patients with ischemic cardiomyopathy(ICM) and dilated cardiomyopathy(DCM) by speckle tracking imaging(STI).Methods Thirty-two patients with ICM,36 cases with DCM and 31 cases of healthy control were selected.The maximum volume(LAVmax),minimum volume(LAVmin) and volume before the systole(LAVp) of the left atria were determined with biplane area-length method,and the total,passive and active ejection fraction of left atria were calculated.The strain and strain rate during systole,ealy and late of diastole(Ss,SRs,Se,SRe,Sa and SRa) were measured at each left atrial wall(septal,lateral,anterior,inferior and posterior).The average values of strain and strain rate were calculated.The correlation of the left atrial ejection fraction and strain rate were analyzed.Results ⑴There was no significant difference during three groups at age,sex,heart rate,IVS and the E wave.Compared with control group,the peak of A wave and LVEF decreased in ICM and DCM groups,while the LAD,LVEDD and E/A increased significantly in the two groups(P<0.05).There were no significant differences between ICM and DCM.⑵Compared with control group,the LAVmax,LAVmin and LAVp increased,while LATEF,LAPEF and LAAEF decreased significantly in patients with ICM and DCM,even lower in DCM group(P<0.05).⑶Compared with control group,the mSs,mSRs,mSe,mSRe,mSa and mSRa reduced significantly in patients with ICM and DCM(P<0.05),and the DCM group decreased more significantly than ICM group(P<0.05).⑷The LATEF had a positive correlation with mSRs(r=0.66,P<0.05).The LATEF had a significant correlation with |mSRe|(r=0.71,P<0.01).The LAAEF had a significant correlation with |mSRa|(r=0.69,P<0.01).Conclusion The accumulation during systole and active emptying function during late diastole were both decreased in ICM and DCM groups,even worse in the latter.The STI may paly an important role in the evaluation of left atrial function.

关 键 词：心肌病 超声心动图描记术 斑点追踪 左心房 

分 类 号：R542.2[医药卫生—心血管疾病]