STI评价川崎病患儿左心室扭转运动变化的研究  

The Assessment of Changes in Left Ventricular Twist of Children with Kawasaki Disease by STI

作　　者：张轶[1] 龙湘党[1] 陈红天[1] 王莉萍[1] 敖琨[1] 谢娟娟[1] 

机构地区：[1]湖南省人民医院超声科,长沙市410005

出　　处：《中国超声医学杂志》2016年第5期426-429,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用斑点追踪成像(STI)技术评估川崎病(KD)患儿急性期及恢复期左心室(LV)扭转参数的变化,探讨扭转参数在评价KD患儿LV心肌力学改变及预后中的临床价值。方法使用STI分析88例KD患儿急性及恢复期LV扭转参数的变化,分为不伴冠状动脉扩张(CAD)组42例,伴CAD组46例,并与常规超声LV功能参数对比。对照组为60例健康儿童。结果 KD急性期常规超声LV功能参数在正常范围内,不伴CAD组收缩期心尖旋转角度峰值、扭转角度峰值及舒张期解旋速度峰值减小(P<0.05);伴CAD组收缩期心尖旋转角度峰值、扭转角度峰值、扭转速度峰值、扭转角度达峰时间、舒张期解旋速度峰值及等容舒张期解旋百分比均减低(P<0.05)。KD恢复期不伴CAD组各扭转参数均与对照组无明显差异(P>0.05);伴CAD组收缩期扭转参数与对照组无明显差异(P>0.05),而舒张期解旋参数仍与对照组有统计学差异(P<0.05)。结论 STI在LV整体功能尚未出现改变时就能敏感地检测KD患儿LV心肌功能的改变;伴CAD组急性期局部冠状动脉供血区心肌功能受损更为明显,且舒张期解旋功能的下降持续至恢复期;舒张期解旋参数的变化更能体现冠状动脉受损的情况。Objective To assess the changes of left ventricular（LV）twist parameters in acute and convalescence stage of children with Kawasaki disease（KD）by speckle tracking imaging（STI）and investigate the clinical value of twist parameters in evaluating changes and prognosis of LV myocardiac mechanics in children with KD.Methods 88 children with KD analyzed by STI were divided 2groups according to the ultrasonic examination：without coronary artery dilation（CAD）group（n=42）and with CAD group（n=46）.Evaluate the changes of LV twist parameters in acute and convalescence stage,and compared with common echocardiography LV functional parameters.The parameters include peak apical rotation（Par）,Peak basal rotation（Pbr）,Peak LV twist（Ptw）,peak twist velocity（PtwV）,time to peak twist（TPK）,peak untwisting velocity（PutwV）,isovolumic untwisting%（Iutw%）.60 health children matched with age were selected as control group.Results The common echocardiography LV functional parameters of children with KD were within the normal limits（P〈0.05）.In acute phase,systolic Par,Ptw and diastolic PutwV of without CAD group decreased（P〈0.05）.Par,Ptw,PtwV,TPK,PutwV and Iutw% of With CAD group decreased（P〈0.05）.In convalescence phase,twist and untwist parameters of patients without CAD were not significant different compared with the controls（P〈0.05）,and the systolic twist parameters in with CAD patients were also not different compared with the controls（P〈0.05）,but diastolic untwist parameters PutwV and Iutw% still had statistics different between with CAD patients and controls（P〈0.05）.Conclusions STI can assess changes of LV myocardiac mechanics sensitively before the global function of LV changed.Regional myocardium supplied by coronary artery may damaged more severely in patients with CAD in acute stage,and the decrease of diastolic untwist parameters keeps on convalescence stage.Untwist parameters may reflect the damage of coronary artery more exactly.

关 键 词：斑点追踪成像 川崎病 左心功能 扭转 

分 类 号：R445.1[医药卫生—影像医学与核医学] R725.4[医药卫生—诊断学]