斑点追踪成像评估阻塞性睡眠呼吸暂停综合征患者左房功能  

Assessment of Left Atrium Function in Patients with Obstructive Sleep Apnea Syndrome by Speckle Tracking Imaging

作　　者：崔超[1] 王志斌[1] 王吴刚[1] 李俊芳[1] 张青洲 

机构地区：[1]青岛大学附属医院心脏超声科,青岛266003 [2]高密市中医院特检科,潍坊261500

出　　处：《影像技术》2017年第2期61-63,60,共4页Image Technology

摘　　要：目的:本研究旨在通过斑点追踪成像(STI),对患有和不患有阻塞性睡眠呼吸暂停综合征(OSAHS)研究对象的左心房功能进行比较,证明使用STI评估该类患者左心房功能,可以早期发现左房的重构和损伤。方法:研究包含90例OSAHS患者和30例正常对照组人群。两组研究对象的年龄、体重指数和血压水平相匹配。所有受检者都要做多导睡眠呼吸检测和超声心动图并进行斑点追踪成像,并根据呼吸暂停低通气指数(AHI)结果将OSAHS患者进行轻度,中度和重度分组。利用斑点追踪技术获得左房应变及应变率曲线,记录左室收缩期、舒张早期及舒张晚期左房应变及应变率。结果:左室舒张早期左房应变和应变率(LAS-E、LASR-E)和左室收缩期左房应变和应变率(LAS-s、LASR-s)随着OSAHS严重程度的增加而减低(P<0.05),左室舒张晚期左房应变和应变率(LAS-a、LASR-a)在中度组轻微升高,而重度组的OSAHS患者LAS-a、LASR-a降低,但与健康组相比增高(P<0.05)。结论:OSAHS能增加左心房功能的负担,导致左心房重构,应用斑点追踪成像在亚临床阶段就可以发现患有OSAHS人群的左房重构和损伤,是一种安全有效的新途径。Objective： Left atrium function in subjects with and without obstructive sleep apnea syndrome （OSAHS） was compared by speckle tracking imaging in this study. The use of STI to assess left atrium function in these patients demonstrates early detection of left atrium remodeling and injury. Methods： The study included 90 patients with OSAHS and 30 normal controls. The age, body mass index and blood pressure level of the two groups were matched. All subjects have to do polysomnography testing and echocardiography and speckle tracking imaging, and the patients with OSAHS were divided into mild, moderate and severe groups according to the results of apnea hypopnea index （AHI）. The use of speckle tracking get left atrium strain and strain rate curve, recording of left ventricular systolic, diastolic early and late diastolic left atrium strain and strain rate. Results： Left atrium strain and strain rate （LAS-E,LASR-E） and left atrium systolic left atrium strain and strain rate （LAS-s, LASR-s） decreased with the severity of OSAHS （P〈0.05）. Ventricular late diastolic left atrium strain and strain rate （LAS-a, LASR-a） increased slightly in the moderate group and severe group of OSAHS patients LAS-a, LASR-a, decrease, but increased compared with the healthy group （P 〈0.05）. Conclusion： OSAHS can increase the burden of left atrium function, leading to left atrium remodeling. The use of speckle tracking imaging is a safe and effective new way that can find the left atrium remodeling and injury in patients with OSAHS in the subclinical stage.

关 键 词：左心房 阻塞性睡眠呼吸暂停综合征 斑点追踪成像 舒张功能减退 

分 类 号：R540.45[医药卫生—心血管疾病] R56[医药卫生—内科学]