三维斑点追踪技术评价初发肾病综合征患儿左心室整体应变  

Three-dimensional speckle tracking imaging in evaluation on global left ventricular strain in children with initial onset of nephrotic syndrome

作　　者：何欢[1] 孙菲菲[1] 任卫东[1] 吴丹[1] 

机构地区：[1]中国医科大学附属盛京医院超声科,辽宁沈阳110004

出　　处：《中国临床医学影像杂志》2016年第8期551-556,共6页Journal of China Clinic Medical Imaging

基　　金：辽宁省科技厅科学技术计划项目(2013225049)

摘　　要：目的：应用三维斑点追踪成像技术（Three—dimensionalspeckletrackingimaging，3D-STI）探讨初发肾病综合征（Initialonsetofnephroticsyndrome，INS）患儿左心室心肌应变的特征，并初步分析在不同24h尿蛋白总量的患儿中上述指标的变化。方法：收集42例INS患儿（病例组）和30例健康儿童（对照组），对所有受检者进行3D-STI检测，获得三维左心室射血分数（Threc—dimensionalleftventficularejectionfraction，3D-LVEF）、左心室心肌整体纵向峰值应变（LeftventficularglobalIon．gitudinalstrain，LVGLs）、左心室圆周峰值应变（Leftventrieularglobalcircumferentialstrain，LVGCS）、左心室面积峰值应变（Leftventricularglobalareastrain，LVGAS）、左心室径向峰值应变（Leftventricularglobalradialstrain，LVGRS），采用正态性检验选取合适的统计学方法进行两组间上述参数的比较，并随机抽取病例组中20例INS患儿进行组内及组间的重复性检验．绘制散点图。随后将INS患儿（病例组）按照24h尿蛋白总量划分为3组，并比较3组内上述参数的差异。结果：①病例组LVEF与对照组比较无明显变化（P〉0．05）。3D—STI中病例组与对照组相比较，LVGAS与LVGIJs明显减低（P均〈0．01），LVGRS和LVGCS无明显变化。②随机抽取病例组中的20例，经Bland—Altman重复性检验后，得出组间LVGAS、LVGCS、LVGLS、LVGRS的平均差值分别为-0．2、-0．13、0．1及0．2，95％置信区间分别为-2．8％～2.3％、-1．65％～1．29％、-2．1％～2．3％及-3．9％～4-3％；组内LVGAS、LVGCS、LVGLS、LVGRS平均差值分别为0．0、-0．36、-0．4及0．1，95％置信区间分别为-2．9％～2．9％、-2．18％～1．45％、-3．2％～2．4％及-4．4％～4．6％。组内及组间INS病例组应变值有良好的可重复性。⑧对按照24h尿蛋白量所划分的3组间的参数进行比较，仅有LVGAS与LVGLS任3组间有明显的统计学差异，�Objective： To evaluate the characters of global left ventricular （LV） strain in children with initial onset of nephrotie syndrome（INS） by three-dimensional speckle tracking imaging（3D-STI） technique. And to analysis the differences of the above data between the children with various amount of urine protein in 24 h. Methods： Forty-two INS children were randomly enrolled as INS group, and 30 healthy children were employed as normal controls. Three-dimensional left ventricular ejection fraction（3D-LVEF）, global left ventricular longitudinal strain（LVGLS）, left ventricular circumferential strain（LVGCS）, left ventricular area strain（LVGAS） and left ventrieular radial strain（LVGRS） were measured with 3D-STI. All of the data were an- alyzed by normality test to find out the proper statistical approaches. Then we choose 20 groups randomly to do the repeata- bility test. Meanwhile, we draw the scatter diagram. At last, we divided the INS group into 3 groups according to their vari- ous amount of urine protein in 24 h. Results： （1）LVGLS and LVGAS were significant lower in INS group than in normal group （all P〈0.05） while LVGCS and LVGRS have no significant differences. （2）After the Bland-Ahman＇s repeatability test, it turned out that the 20 groups which were chosen randomly are in good correspondence with each other not only between- group but also in-group. Compared with between-group, the mean difference value of LVGAS, LVGCS, LVGLS and LVGLS are -0.2, -0.13, 0.1 and 0.2 respectively as well as the confidence interval of them are -2.8%-2.3%, -1.65%N1.29%, -2.1% -2.3% and -3.9%-4.3% respectively. When compared with in-group, the mean difference value of LVGAS, LVGCS, LVGLS and LVGLS are 0.0, -0.36, -0.4 and 0.l respectively as well as the confidence interval of them are -2.9%-2.9%, -2.18%- 1.45%, -3.2%-2.4% and -4.4%-4.6% respectively. （3）Compared the data among the 3 INS subgroups, it can be inferred thatonly LVGAS and LVGLS make the significant differences. can g

关 键 词：肾病综合征 儿童 超声心动描记术 

分 类 号：R692[医药卫生—泌尿科学] R540.45[医药卫生—外科学]