二维斑点追踪技术评价败血症新生儿左心室收缩功能  

Assessment of left ventricular systolic function in neonatal sepsis by using two-dimensional speckle tracking imaging

作　　者：李陶[1] 刘娟娟[1,2] 杜文华[1] 王翔[1] 陈志强[3] 张良潮[3] 

机构地区：[1]第三军医大学大坪医院野战外科研究所超声科,重庆400042 [2]湖北医药学院附属襄阳医院超声科,湖北襄阳441100 [3]第三军医大学大坪医院野战外科研究所第六研究室,重庆400042

出　　处：《中国医学影像技术》2014年第8期1194-1198,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的应用超声斑点追踪(STI)技术评价败血症新生儿收缩功能变化。方法收集足月败血症新生儿25名为病变组,足月正常健康新生儿25名为对照组,检测血清中肌酸激酶(CK)、肌酸激酶心肌同工酶(CK-MB)的浓度,进行常规超声心动图和STI检查。常规超声心动图指标:用Simpson法测得左心室射血分数(LVEF)、心输出量(CO),用M型超声测得缩短分数(LVFS)。STI指标:左心室长轴整体纵向峰值应变/应变率(GLS/GLSr)、左心室短轴整体圆周峰值应变/应变率(GCS/GCSr)、左心室短轴整体径向峰值应变/应变率(GRS/GRSr)、左心室整体径向位移(GRAD)、左心室整体径向速度(GRAV)、左心室整体旋转位移(GROD)、左心室整体旋转速度(GROV)。结果病变组心肌损伤指标CK、CKMB明显高于对照组(P<0.05),病变组与对照组比较,常规超声指标LVEF、LVFS、CO无明显差异(P<0.05)。病变组STI指标除了GRS、GRSr、GROD无明显变化外(P<0.05),GLS、GLSr、GCS、GCSr、GRAD、GRAV、GROV均明显低于对照组(P<0.05)。结论对于新生儿败血症,STI能比常规超声心动图更早地发现败血症新生儿左心心肌功能异常,是一种准确、敏感地评估新生儿败血症心功能损伤的有效手段。Objective To evaluate the cardiac function in neonatal sepsis using two-dimensional speckle tracking imaging（2D-STI）.Methods Twenty five full-term neonatus with sepsis were enrolled as case group,and 25 neonates of full term normal delivery were selected as control group.The concentration of serum CK,CK-MB in the blood was detected.The parameters of conventional echocardiography and 2D-STI were obtained.Conventional echocardiography measures included left ventricular ejection fraction（LVEF）was calculated using Simpson＇s method and left ventricular fractional shortening was calculated by standard M-mode measurements.Cardic output（CO）,left ventricular fractional shortening（LVFS）was calculated by standard M-mode measurements.STI measures included left ventricular global longitudinal strain（GLS）/strain rate（GLSr）,left ventricular global circumferential strain（GCS）/strain rate（GCSr）,left ventricular global radial strain（GRS）/strain rate（GRSr）,global radial displacement（GRAD）,global radial velocity（GRAV）,global rotational displacement（GROD）,global rotational velocity（GROV）.Results The level of serum CK,CK-MB in case group was higher than control group（P〈0.05）.Left ventricular conventional echocardiographic parameters did not show significant alterations（all P〈0.05）.Except GRS/GRSr,GROD（all P〈0.05）,the other parameters were significantly impaired in case group when compared to the control group（P〈0.05）.Conclusion STI can detect myocardial dysfunction in neonatal septicemia that not found by conventional echocardiogram in subclinical stage,it can be more earlier and sensitive to detect the myocardial injury in sepsis.

关 键 词：斑点追踪显像 败血症 心肌损伤 婴儿 新生 心室功能 左 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541[医药卫生—诊断学]