美托洛尔对肥厚型心肌病患者左心室收缩功能影响的三维应变研究  

Three-dimensional speckle tracking imaging in evaluating metoprolol effect on left ventricular systolic function in patients with hypertrophic cardiomyopathy

作　　者：姚丙南 仇萍 韩世琴 李建新 王爱国 吉越英 解婷婷 

机构地区：[1]兴化市人民医院心内科,江苏兴化225700 [2]兴化市人民医院超声科,江苏兴化225700

出　　处：《中华实用诊断与治疗杂志》2015年第5期510-512,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的探讨肥厚型心肌病(hypertrophic cardiomyopathy,HCM)患者应用美托洛尔短期治疗前、后左心室收缩功能的变化。方法 HCM患者27例(HCM组),均给予酒石酸美托洛尔治疗,分别于治疗前及治疗3个月后行超声心动图检查,应用三维斑点追踪(three-dimensional speckle tracking imaging,3D-STI)技术测量左心室心肌收缩期整体纵向应变(global longitudinal strain,GLS)、左心室整体圆周应变(global circumferential strain,GCS)以及左心室整体径向应变(global radial strain,GRS),应用脉冲多普勒测量左心室流出道最大瞬时压差(left ventricular outflow tract pressure gradient,LVOT-PG)等参数,并与同期30例体检健康者(对照组)进行比较。结果 HCM组治疗前GLS[(-17.6±2.7)%]低于对照组[(-22.1±4.9)%],GRS[(102.7±33.8)%]及GCS[(-30.2±2.5)%]较对照组[GRS为(86.7±34.1)%,GCS为(-23.5±3.2)%)]增强(P<0.05),LVOT-PG[68.0(27.0,109.0)mm Hg]高于对照组[5.1(3.2,7.8)mm Hg](P<0.05);治疗3个月后,HCM组GLS[(-16.9±3.8)%]与治疗前比较差异无统计学意义(P>0.05),GRS[(93.7±31.5)%]、GCS[(-27.1±2.8)%]、LVOT-PG[34.0(17.0,69.0)mm Hg]较治疗前降低(P<0.05),但HCM组治疗后LVOT-PG仍高于对照组(P<0.05),GRS、GCS仍较对照组增强(P<0.05)。结论美托洛尔可降低HCM患者LVOT-PG以及左心室GRS、GCS,3D-STI技术可为HCM治疗效果的评价提供新的方法。Objective To explore the changes of left ventricular systolic function before and after treatment with metoptolol in patients with hypertrophic cardiomyopathy（HCM）.Methods Twenty-seven patients with HCM（HCM group）were measured global longitudinal strain（GLS）,global circumferential strain（GCS）and global radial strain（GRS）of left ventricle by three-dimensional speckle tracking imaging（3D-STI）,and were measured left ventricular outflow tract pressure gradient（LVOT-PG）by pulse Doppler before and after 3-month treatment with metoprolol,which were compared with another 30 health volunteers（control group）.Results GLS was lower in HCM group（（-17.6±2.7）%）than that in control group（（-22.1±4.9）%）,GRS and GCS were higher in HCM group（（102.7±33.8）%,（-30.2±2.5）%）than those in control group（（86.7±34.1）%,（-23.5±3.2）%））,and LVOT-PG was higher in HCM group（68.0（27.0,109.0）mm Hg）than that in control group（5.1（3.2,7.8）mm Hg）（P0.05）before treatment.GRS,GCS and LVOT-PG were significantly lower after 3-month treatment（（93.7±31.5）%,（-27.1±2.8）%,34.0（17.0,69.0）mm Hg）than those before treatment in HCM group（P0.05）,and significantly higher than those in control group（P0.05）.There was no significant difference in GLS after 3-month treatment（（-16.9±3.8）%）in comparison with that before treatment in HCM group（P0.05）.Conclusion Metoprolol can significantly reduce LVOT-PG,GRS and GCS.3D-STI can be used as a new method for assessing the therapeutic effect on HCM.

关 键 词：肥厚型心肌病 美托洛尔 超声心动图 三维斑点追踪技术 

分 类 号：R542.2[医药卫生—心血管疾病]