斑点追踪技术及实时三维超声心动图评价心脏移植患者左心室扭转及节段功能  

Evaluation of left ventricular torsion and segmental function by speckle tracking imaging and real-time threedimensional echocardiography in patients with heart transplant

作　　者：潘翠珍[1] 舒先红[1] 孙敏敏[1] 姚豪华[1] 陈昊[2] 王春生[2] 

机构地区：[1]复旦大学附属中山医院上海市心血管病研究所心超室,上海200032 [2]复旦大学附属中山医院上海市心血管病研究所心外科,上海200032

出　　处：《中华超声影像学杂志》2010年第8期649-654,共6页Chinese Journal of Ultrasonography

基　　金：基金项目：上海市自然科学基金（09ZR1406300）

摘　　要：目的 探讨斑点追踪技术及实时三维超声心动图评价心脏移植患者心脏扭转及节段功能的应用价值.方法 应用Philips iE33超声显像仪,X3-1探头,及GE Vivid 7彩色多普勒超声显像仪,M3S探头,对20例心脏移植患者和20例正常对照者进行二维及实时三维超声心动图检查.结果 正常对照组20例中有2例（10%）心尖部呈顺时针旋转,而心脏移植组20例中有8例（40%）心尖部呈顺时针旋转.将心脏移植组分为A组（心尖部呈逆时针旋转）和B组（心尖部呈顺时针旋转）,心脏移植A组前间隔、后壁、下壁及后间隔心尖部旋转角度收缩期峰值较正常对照组低（P＜0.05）,心脏移植B组心尖水平各节段的旋转角度收缩期峰值均较正常对照组低（P均＜0.05）,A组和B组心尖水平各节段的旋转率收缩期峰值与正常对照组比较差别无统计学意义（P均＞0.05）;B组心尖水平各节段的峰值旋转率舒张早期峰值及舒张晚期峰值均较正常对照组及A组明显增高（P＜0.05）,而A组与正常对照组心尖水平各节段的峰值旋转率舒张早期峰值及舒张晚期峰值比较差别无统计学意义（P＞0.05）.心脏移植A组和B组的位移与正常对照组比较差别无统计学意义（P＞0.05）,而B组左室扭转角度较正常对照组及A组低（P＜0.05）;心脏移植A组和B组的17节段时间-容积曲线参数指标：16节段时间的标准差（Tmsv 16-SD）、12节段时间的标准差（Tmsv 12-SD）、6节段时间的标准差（Tmsv 6-SD）、16节段时间的最大差（Tmsv 16-Dif）、12节段时间的最大差（Tmsv 12-Dif）、6节段时间的最大差（Tmsv 6-Dif）以及经心率校正的Tmsv 16-SD（%）、Tmsv 12-SD（%）、Tmsv 6-SD（%）、Tmsv 16-Dif（%）、Tmsv 12-Dif（%）、Tmsv 6-Dif（%）与正常对照组比较差别无统计学意义（P＞0.05）.结论 斑点追踪技术及实时三维超声心动图能快速评价心脏移植患者左室扭转及各节段收缩功�Objective To evaluate left ventricular torsion and systolic function of the segment by speckle tracking imaging（STI） and real-time three-dimensional echocardiography（RT-3DE） in patients with heart transplantation. Methods Twenty patients with heart transplantation and twenty subjects with normal left ventricular function were examined by Philips iE33 with a X3-1 probe and GE Vivid 7 with M4S probe.Results There were two subjects（100% ） with clockwise rotation in control group patients, but eight patients （40 % ） with clockwise rotation in heart transplantation group. And heart transplantation group were divided into two sub-groups （group A with counterclockwise rotation and group B with clockwise rotation） based on the direction of rotation. In apical level,the systolic peak of the angle of rotation of anterior septum,posterior wall,inferior wall, posterior septum in group A was less than that of control group（ P 〈0.05）, all segmental systolic peak of the angle of rotation in group B was reduced compared with control group（ P 〈0. 05）,however all segmental systolic peak of rate of rotation in group A and group B was not significant different compared with control group （ P 〉0. 05） ,all segmental diastolic peak in early and late of rate of rotation in group B was obviously higher than that in control group and group A （ P 〈0. 05）, while all segmental diastolic peak in early and late of rate of rotation in group A was not significant different compared with control group（ P 〉0.05）. The displacement and the parameter index of 17 segment time to minimal systolic volume in group A and group B were not significant different compared with control group（ P 〉0. 05）, but left ventricular angle of torsion was decreased in group B compared with control group and group A（ P 〈0.05）. Conclusions STI and RT-3DE can rapidly evaluate function of left ventricular torsion and function of segmental systole and systolic synchrony in patients with heart transplant.

关 键 词：超声心动描记术 实时三维 心脏移植 心室功能 左 斑点追踪显像 

分 类 号：R654.2[医药卫生—外科学] R445.1[医药卫生—临床医学]