左房节段二维应变参数鉴别缩窄性心包炎和限制型心肌病的价值  

The Differentiation between Constrictive Pericarditis and Restrictive Cardiomyopathy Using Regional Left Atrial 2D Strain Parameters

作　　者：刘爽[1] 任卫东[2] 马春燕[1] 张晶[2] 杨军[1] 肖杨杰[2] 张妍[2] 王永槐[1] 

机构地区：[1]中国医科大学附属第一医院心血管超声科,沈阳市110001 [2]中国医科大学附属盛京医院超声科

出　　处：《中国超声医学杂志》2016年第2期140-142,共3页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然基金面上项目(No.81571686)

摘　　要：目的应用超声斑点追踪技术(STE)评价缩窄性心包炎(CP)及限制型心肌病(RCM)患者左房节段心肌功能,探讨其在鉴别CP及RCM中的作用。方法对35例CP患者及30例RCM患者应用斑点追踪技术测量左房侧壁及房间隔收缩期应变(S)及应变率(SrS)、舒张早期应变率(SrE)、舒张晚期应变率(SrA)。结果(1)CP患者房间隔S、SrS、SrE、SrA较RCM患者明显增加(P<0.05),房间隔SrE以1.40为截点值鉴别CP和RCM的灵敏度和特异度分别为94.7%和89.7%(AUC=0.97,P<0.05)。结论 STE可以准确评价CP患者及RCM患者节段左房功能,并在二者的鉴别诊断中具有重要作用。Objective To evaluate regional left atrial functions using two-dimensional speckle tracking echocardiography（STE）in patients with constrictive pericardium（CP）and restrictive cardiomyopathy（RCM）,and its clinical value in the differentiation between CP and RCM.Methods 35 patients with CP and 30 patients with RCM were enrolled in the study.The atrial longitudinal peak systolic strain（S）,peak systolic stain rate（SRs）,peak early diastolic stain rate（SRe）and peak late diastolic strain rate（SRa）in the interatrial septum and the lateral wall of the left atrium were measured using STE.Results S,SRs,SRe,SrA of the interatrial septum were increased in patients with CP than those in the CP group（P〈0.05）.The sensitivity and specificity of SrE of the interatrial septum in diagnosis of CP were 94.7% and 89.7% respectively,with a cut-off value of 1.40（area under ROC curve=0.97,P〈0.05）.Conclusions Strain rate can evaluate the regional left atrial myocardial function in patients with CP and RCM exactly.STE are readily obtained parameters that provide unique data in the differentiation between CP and RCM.

关 键 词：缩窄性心包炎 限制型心肌病 应变率 

分 类 号：R445.1[医药卫生—影像医学与核医学] R542.2[医药卫生—诊断学] R542.11[医药卫生—临床医学]