左室心肌致密化不全与肥厚型心肌病的超声心动图比较  

Comparison of echocardiography in patients with left ventricular noncompaction and hypertrophic cardiomyopathy

作　　者：李赐恩[1] 宋卫锋 冯勤勤 李莉锦 贾晓艳[1] 孙琳琳[4] 韩战营[1] 邱春光[1] LI Ci＇en SONG Weifeng FENG Qinqin LI Lijin JIA Xiaoyan SUN Linlin HAN Zhanying QIU Chunguang(Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China Department of Cardiology, People＇s Hospital of Zhengzh0u University College of Pharmacy, Linyi University Department of Ultrasound, the First Affiliated Hospital of Zhengzhou University)

机构地区：[1]郑州大学第一附属医院心血管内科,郑州450052 [2]郑州大学人民医院心血管内科 [3]临沂大学药学院 [4]郑州大学第一附属医院超声科

出　　处：《临床心血管病杂志》2017年第9期854-857,共4页Journal of Clinical Cardiology

摘　　要：目的:探讨左室心肌致密化不全(LVNC)和肥厚型心肌病(HCM)相关超声心动图的参数,分析比较二者整体及局部心功能的差别。方法:分析2015-01-2017-01在郑州大学第一附属医院诊断为LVNC的患者30例(LVNC组)、HCM患者30例(HCM组)。通过常规超声心动图分析比较两组患者的肌小梁数目、最大室壁厚度(MWT)、左室射血分数(LVEF)。通过二维斑点追踪成像技术(two-dimensional speckle tracking imaging,2D-STI)比较2组患者左心整体纵向应变性(global longitudinal strain,GLs)及左室基底部和心尖部的节段纵向应变性(section longitudinal strains,SLs)。结果:(1)与HCM组相比,LVNC组肌小梁数目显著增加[(8.47±3.54)个∶(1.20±1.67)个,P<0.01]、MWT显著减小[(9.97±1.88)mm∶(18.04±2.15)mm,P<0.01]、LVEF显著减低[(41.77±8.07)%∶(55.87±4.11)%,P<0.01],但2组患者左心GLs无统计学差异[(-14.04±2.59)%∶(-15.30±2.67)%,P=0.069]。(2)HCM组基底部至心尖部SLs显著增加[(-13.29±2.68)%∶(-19.17±2.72)%,P<0.001)],但LVNC组基底部和心尖部SLs无统计学差异[(-13.07±2.56)%∶(-14.26±2.55)%,P=0.075]。结论:LVNC一般伴随着肌小梁数目的增加、MWT变薄、LVEF降低,并且基底部-心尖部心功能梯度消失,但HCM基底部心功能减低更为明显,且基底部至心尖部心功能存在一定梯度。上述特征有助于LVNC和HCM的鉴别。Objective：To compare echocardiographic parameters in left ventricular noncompaction（LVNC）and hypertrophic cardiomyopathy（HCM）,and investigate the difference of the global and regional cardiac function in the two groups.Method：Thirty patients with LVNC and 30 patients with HCM who diagnosed in the First Affiliated Hospital of Zhengzhou University from January 2015 to January 2017 were enrolled in this study.The numbers of trabeculations,maximal wall thickness（MWT）,left ventricular ejection fraction（LVEF）of the two groups were compared by routine echocardiography examination.Two-dimensional speckle tracking imaging（2D-STI）was used to compare two groups＇ global longitudinal strain and section longitudinal strains of LV basal and apical.Result：（1）More trabeculations[（8.47±3.54）vs（1.20±1.67）,P〈0.01],thinner MWT thinner[（9.97±1.88）mm vs（18.04±2.15）mm,P〈0.01]and lower LVEF[（41.77±8.07）% vs（55.87±4.11）%,P〈0.01]were observed in LVNC compared to HCM,but with no significantly differences in LV global longitudinal strain[（-14.04±2.59）% vs（-15.30±2.67）%,P=0.069].（2）Function by longitudinal strain increased significantly from base to apex in HCM[（-13.29±2.68）% vs（-19.17±2.72）%,P〈0.01）],but not in LVNC[（-13.07±2.56）% vs（-14.26±2.55）%,P=0.075].Conclusion：LVNC is usually accompanied by an increase in the number of trabeculations,and decreases in the MWT and the LVEF decreased,and absence of the apical to basal gradient,however,the basal cardiac function reduced more obvious in HCM with preserved and the apical to basal gradient.The characteristics above contribute to the discrimination of LVNC and HCM.

关 键 词：左室心肌致密化不全 肥厚型心肌病 超声心动图 纵向应变性 

分 类 号：R542.2[医药卫生—心血管疾病]