纵向应变及峰值应变离散度评价睡眠呼吸暂停综合征患者左心室收缩功能  

Longitudinal strain and peak strain dispersion in evaluating left ventricular systolic function in patients with sleep apnea syndrome

作　　者：张苗 袁建军 魏常华 刘会芳 丁晓 李杨 谷春红 黑晶晶 Zhang Miao;Yuan Jianjun;Wei Changhua;Liu Hui fang;Ding Xiao;Li Yang;Gu Chunhong;Hei Jingjing(Department of Ultrasound,Peoplels Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]郑州大学人民医院超声科,450003

出　　处：《中华超声影像学杂志》2018年第9期748-751,共4页Chinese Journal of Ultrasonography

基　　金：河南省科技攻关计划项目（201602212）

摘　　要：目的探讨纵向收缩峰值应变（GLS）、峰值应变离散度（PsD）在评价阻塞性睡眠呼吸暂停综合征（OSAS）患者左心室心肌同步性及收缩功能中的价值。方法选取经多导睡眠仪监测呼吸暂停指数（AHI）≥5次／h确诊为0SAS的男性患者70例（病例组）及男性健康志愿者26例（对照组），并根据AHI将OSAS患者分为轻度组、中度组、重度组。比较各组的左室射血分数（LVEF）、舒张压、收缩压、左心室舒张末期内径（LVDd）、左心室收缩末期内径（LVDs）、左房内径（LAD）、室间隔厚度（IVST）、左心室后壁厚度（LVPW）及GLS、PSD，并进行GLS、PSD与AHI之间的相关性分析。结果①OSAS中轻度组、中度组、重度组及对照组组间年龄、身高、体重、体质指数（BMI）、LVEF、舒张压、收缩压、LVDd、LVDs、LAD、LVPW差异无统计学意义（P〉0．05），重度组IVST较对照组增加（P〈0．05）。②中、重度组分别与对照组、轻度组比较，PSD增加，GLS降低，差异有统计学意义（P〈0．05）；重度组与中度组比较，OLS下降，差异有统计学意义（P〈0．05）；其他参数各组间差异无统计学意义（P〉0．05）。③Pearson相关分析显示AHI与GLS（r^2=0．5026）、PSD（r^2=0．6845）相关（P〈0．05）。结论GLS、PSD能够早期评价OSAS患者左心室心肌同步性及收缩功能变化。Objective To evaluate the value of longitudinal peak strain （GLS） and peak strain dispersion （PSD） in left ventricular myocardial synchrony and systolic function in patients with obstructive sleep apnea syndrome （ OSAS ）. Methods Seventy male patients with OSAS diagnosed by polysomnography and 26 healthy volunteers were enrolled in this study. According to AHI, the OSAS patients were divided into three groups： mild group, moderate group and severe group. Echocardiography was performed on the next day. The Left ventricular ejection fraction （LVEF）, diastolic blood pressure, systolic blood pressure, left ventricular end-diastolic diameter （LVDd）, left ventricular end-systolic diameter （LVDs）, left atrial diameter （LAD）, interventricular septum thickness （IVST）, left ventricular posterior wall thickness （LVPW）, global systolic longitudinal strain（GLS） and peak strain dispersion （PSD） were compared among four groups. The correlation between GLS, PSD and AHI were analyzed. Results （1）Age, height,weight, body mass index （BMI）, LVEF, diastolic blood pressure, systolic blood pressure, LVDd, LVDs, LAD and LVPW were not statistically different among the OSAS mild, moderate, severe group and control group （ P〉0.05）. IVST in severe groups was increased than that in control group （P〈0.05）. （2） Compared with the control group and the mild group, the PSD increased and the GLS decreased significantly in the moderate and severe groups （ P 〈0. 05）, and there was a statistically significant decrease in the GLS between the severe group and the moderate group （P〈0. 05）. There was no statistical difference in other parameters among 4 groups （ P 〉0.05）. （3）Pearson correlation analysis showed that AHI was associated with GLS（r^2 = 0. 5026） and PSD（r^2 = 0. 6845） （P〈0.05）. Conclusions GLS and PSD can early evaluate the left ventricular myocardial synchrony and systolic function changes in patients with OSAS.

关 键 词：三维斑点追踪显像 睡眠呼吸暂停 阻塞性 纵向收缩峰值应变 峰值应变离散度 

分 类 号：R766[医药卫生—耳鼻咽喉科] R445.1[医药卫生—临床医学]