二维斑点追踪技术对缺血性心肌病和扩张型心肌病患者左心房功能的研究  

Evaluation of left atrial function in ischemic cardiomyopathy and dilated cardiomyopathy patients by twodimensional-speckle tracking imaging

作　　者：汪迎晖[1] 曹省[1] 陈金玲[1] 郭瑞强[1] 胡波[1] 黄佳[1] 

机构地区：[1]武汉大学人民医院超声影像科,430060

出　　处：《中华超声影像学杂志》2012年第7期570-574,共5页Chinese Journal of Ultrasonography

摘　　要：目的应用二维斑点追踪技术（2D-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。方法选择ICM患者22例、DCM患者26例和健康对照者32例，采用双平面法测量左房最大容积（LAVmax）、最小容积（LAVmin）、收缩前容积（LAVp），并计算左房总的排空容积（LATV）、膨胀指数（AEI）、主动排空容积（LAEV）、主动射血分数（LAEF）。运用2D-STI测量左房房间隔、侧壁、前壁、下壁的收缩期应变（ss）、应变率（SRs），舒张晚期应变（Sa）、应变率（SRa）。计算出所有房壁的平均应变及应变率，并分析左房功能指标与应变率之间的相关性。结果①三组受检者的年龄、性别、心率、E峰等指标差异无统计学意义。ICM组和DCM组A峰、E峰减速时间（DT）、左室射血分数（LVEF）较对照组减小，左房前后径（LAD）、左室舒张末期内径（LVEDD）、E／A则增大（P〈0．05），ICM组和DCM组之间差异无统计学意义。②与对照组相比，ICM组和DCM组LAVmax显著增大，而AEI、LAEF则降低，差异有统计学意义（P〈O．05）；与ICM组相比，DCM组AEI、LAEF更低（P〈0．05）。③与对照组相比，ICM组和DCM组Ss、SRs、Sa和SRa均降低（P〈O．05），且DCM组降低更显著（P〈O．05）。④AEI与SRs呈较好的正相关（r=0．765，P〈0．01）；LAEF与SRa具有较强的相关性（r=0．830，P〈0．01）。结论ICM和DCM患者收缩期左房储血功能和舒张晚期主动射血功能均降低，且DCM患者较ICM患者降低更明显。2DSTI技术能较好地评价左房功能。Objective To evaluate left atrial function in patients with ischemic cardiomyopathy（ICM） and dilated cardiomyopathy （DCM） by two dimensional-speckle tracking imaging （2D-STI）. Methods Twenty two patients with ICM, twenty-six with DCM and thirty-two healthy subjects were studied. The maximum volume（LAVmax）,minimum volume（LAVmin） and volume before the systole（LAVp） of left atria were acquired using biplane area length method,and calculated the total emptying volume（LATV）, expansion index（AEI）,active emptying volume（LAEV） and fraction（LAEF） of left atria. The strain and strain rate during systole and late of diastole（Ss, SRs, Sa and SRa） were measured at each left atrial wall （septal,lateral,anterior and inferior）. The average of them were worked out. The correlation of left atrial function and strain rate were analysed. Results No significant differences were found at the age,sex,heart rate and the E wave between the mitral leaflet tips during all the groups. Compared with the control group, the peak of A wave, the deceleration time of E 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. Compared with the controls, the LAVmax increased, AEI and LAEF decreased significantly in patients with ICM and DCM, even lower in DCM（ P 〈0.05）. Compared with the controls, the Ss, SRs, Sa and SRa reduced significantly in patients with ICM and DCM（ P 〈0.05）, and the DCM showed much significant differences than ICM（ P 〈0.05）. The AEI had a positive correlation with SRs（ r = 0. 765, P 〈0.01 ）. The LAEF had a significant correlation with SRa（ r = 0. 830, P 〈0.01）.Conclusions The accumulation during systole and active emptying function during late of diastole are both lower in ICM and I）CM,even worse in the latter. The 2D-STI may paly an important role in the evaluation of left atrial function.

关 键 词：超声心动描记术 心肌病 扩张型 心肌梗死 心房功能 左 斑点追踪显像 

分 类 号：R542.2[医药卫生—心血管疾病]