二维斑点追踪技术对评价左室射血分数保留的心力衰竭的价值  

The value of 2-dimensional speckle tracking imaging in evaluating heart failure with persevered left ventricular ejection fraction

作　　者：陈晓梅[1,2] 张丽丽[1] 李红瑜[1] 张帆[1] 张超[1] 赵丽荣[1] 

机构地区：[1]吉林大学第一医院超声科,吉林长春130021 [2]青岛市市立医院

出　　处：《中国实验诊断学》2015年第6期940-943,共4页Chinese Journal of Laboratory Diagnosis

基　　金：2011年吉林省科技厅项目(20110451)

摘　　要：目的本研究应用二维斑点追踪成像(2DSTI)技术,比较左室射血分数保留的心力衰竭(HFPEF)患者及无症状的左室舒张功能障碍(LVDD)患者的左室舒张功能及心肌运动同步性,并观察其与血浆N末端B型钠尿肽前体(NT-pro BNP)之间的相关性。方法实验组HFPEF 25例,对照组无症状的LVDD 25例。测量血浆NT-pro BNP水平;采集左室心尖二腔、三腔、四腔心观动态图像,应用2DSTI分析测量。结果实验组舒张早期应变率峰值(GLSRe,02-LSRe,03-LSRe,04-LSRe)明显减低(P<0.05);16节段、12节段收缩应变达峰时间的标准差(Ts-SD16、Ts-SD12)增大,任意对应两节段的收缩应变达峰时间的最长时间间隔(Ts-diff)延长(P<0.05)。Log NT-pro BNP与GLSRe,02-LSRe,03-LSRe,04-LSRe、Ts-SD16显著相关(P<0.05)。结论 2DSTI能够较为准确地评价舒张功能,区分其受损程度;同时可测定心肌运动的不同步性,为HFPEF的诊断和治疗提供新的思路。Objective To assess the diastolic function and synchronicity of heart failure with persevered left ventricular ejection fraction（HFPEF）patients and asymptomatic with left ventricular diastolic dysfunction（LVDD）patients using two dimensional speckle-tracking imaging（2DSTI）and observe the correlation between the 2DSTI measured indicators and plasma NT-pro BNP levels.Methods Patients with HFPEF 25 examples,and a control group of asymptomatic with LVDD 25 examples,determined of the plasma NT- pro BNP level,collected apical four-chamber,threechamber,two-chamber view dynamic two-dimensional image,analysed by 2DSTI.Results HFPEF patients＇ global and two-chamber,three-chamber,four-chamber early diastolic strain rate（GLSRe,02-LSRe,03-LSRe,04-LSRe）was significantly lower than the asymptomatic with LVDD group（P〈0.05）;the value of 16,12segments＇ Ts-SD,Ts-diff is bigger（P〈0.05）.LogNT-pro BNP and GLSRe,02-LSRe,03-LSRe,04-LSRe,Ts-SD16 were significantly correlated.Conclusion 2DSTI had higher sensitivity to evaluate the diastolic dysfunction＇s degree.it can determine the synchronicity of myocardial activity,provides a new thought of the diagnosis and treatment of HFPEF.

关 键 词：左室射血分数保留的心力衰竭 无症状的左室舒张功能障碍 二维斑点追踪成像技术 N末端B型钠尿肽前体 

分 类 号：R541.6[医药卫生—心血管疾病]