二维斑点追踪成像技术评价阻塞性睡眠呼吸暂停低通气综合征患者早期右心室局部收缩功能改变  

Evaluation of Subclinical Regional Right Ventricular Systolic Function Using the 2D Speckle Tracking Imaging in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

作　　者：贾梅 杨明武 纳丽莎 汤翠翠 朱睿 吴丹 JIA Mei;YANG Mingwu;NA Lisha;TANG Cuicui;ZHU Rui;WU Dan(Department of Cardiac Center Examination Function of Heart Center,the General Hospital of Ningxia Medical University,Yinchuan 750004;Department of Anesthesiology,the General Hospital of Ningxia Medical University,Yinchuan 750004)

机构地区：[1]宁夏医科大学总医院心脏中心功能部,银川750004 [2]宁夏医科大学总医院心脑血管病医院麻醉科,银川750004

出　　处：《宁夏医科大学学报》2018年第6期671-675,共5页Journal of Ningxia Medical University

摘　　要：目的应用二维斑点追踪成像(2D-STI)技术评价不同程度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者早期右心室局部收缩功能改变。方法选择83例经多导睡眠呼吸监测(PSG)诊断为OSAHS的患者,按呼吸暂停低通气指数(AHI)分为3组:轻度组、中度组、重度组。选取20例健康体检者作为对照组,分别通过2D-STI测量各组OSAHS患者及对照组右心室游离壁及室间隔各节段收缩期纵向应变、应变率,并进行对比分析。结果 OSAHS患者的AHI随病情严重程度增加而增大(P<0.05)。中度组、重度组OSAHS患者右室前壁厚度及右室游离壁厚度均大于对照组和轻度组(P均<0.05),各组OSAHS患者右心室长径、右心室中段横径、右心室基底横径、右心室流出道内径、主肺动脉内径、肺动脉收缩压、右心室射血分数与对照组比较差异均无统计学意义(P均>0.05)。轻度组右心室游离壁基底段应变、应变率均大于对照组(P均<0.05),中间段及心尖段应变、应变率与对照组比较差异无统计学意义(P均>0.05)。轻度组室间隔各节段应变、应变率与对照组比较差异无统计学意义(P均>0.05);中度组、重度组右心室游离壁及室间隔各节段应变、应变率均小于对照组及轻度组(P均<0.05);重度组右心室游离壁及室间隔各节段应变、应变率均小于中度组(P均<0.05)。结论 2D-STI能够检测OSAHS患者早期右心室局部收缩功能改变。Objective To evaluate the subclinical regionalright ventrieular systolic function by 2D speckle tracking imaging （2D-STI）in patients with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods A total of 83 patients with OSAHS were divided into the three groups according to the degree of apnea hypoventilation index （AHI）： mild group ,moderate group, severe group. 20 healthy controls were involved as the control group. The right ventricular free wall myocardial and interventricular septum strain and strain rate curve were measured by 2D-STI examination. Results The AHI of OSAHS increased with the severity of the disease （P〈0.05）. The thickness of right ventricular anterior wall and the thickness of right ventricular free wall in moderate group and severe group of OSAHS were greater than that of control group and mild group（P〈0.05 ）. There was no significant difference between the conventional echocardiography parameters and the control group （P〉0.05）. In the mild group, the strain and strain rate of the basal segment of the fiee wall of the right ventricle was greater than that of the control group （P〈0.05）. There was no significant difference in the strain and strain rates of the middle and apical segments compared with the control group （P〉0.05）. There was no significant difference in strain and strain rates of each segment between the mild group interval and the control group （P〉0.05）. The strain and strain rates of the right ventricular free wall and the interventricular septum in the moderate and severe groups were smaller than those of the control group and the mild group（P〈0.05）. The strain and strain rates of the right ventricular septum and the interventricular septum in the severe group were less than the moderate group（P〈0.05）. Conclusion 2D-STI can detect early changes of right ventricular systolic function in OSAHS patients.

关 键 词：二维斑点追踪 阻塞性睡眠呼吸暂停低通气综合征 右心室局部收缩功能 

分 类 号：R766[医药卫生—耳鼻咽喉科] R445[医药卫生—临床医学]