二维斑点追踪技术评价川崎病患儿左心室收缩功能  

The study of left ventricular systolic function in Kawasaki disease evaluated by two dimensional speckle tracking imaging

作　　者：王海永[1] 童明辉[1] 吴婷婷[1] 雷海燕[1] 王佳冰[1] 丁新华[1] Wang Haiyong;Tong Minghui;Wu Tingting;Lei Haiyan;Wang Jiabing;Ding Xinhua(Department of Ultrasound,Children Hospital,Lanzhou Second Hospital,Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第二医院儿童医院超声科,730000

出　　处：《中华医学超声杂志（电子版）》2018年第9期692-699,共8页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：甘肃省自然科学基金(17JR5RA251)

摘　　要：目的运用二维斑点追踪技术评价川崎病(KD)患儿不同时期左心室收缩期节段及整体峰值应变及应变率变化,并分析左心室应变及应变率与常规超声心动图参数及实验室指标的相关性。方法选取2016年1至12月兰州大学第二医院儿童医院急性期诊断为KD住院患儿50例,其中18例患儿合并冠状动脉扩张,32例患儿冠状动脉正常。选取同期以心脏杂音来该院门诊就诊,但超声心动图检查结果正常的患儿30例作为对照组。运用常规超声心动图及二维斑点追踪技术分别于急性期(静脉注射免疫球蛋白前,IVIG前)、亚急性期(IVIG后1周)及恢复期(IVIG后8周)获取常规超声心动图参数及收缩期左心室整体峰值纵向应变(GLS)及应变率(GLSR)、收缩期整体峰值环向应变(GCS)及应变率(GCSR)、收缩期左心室各节段收缩期峰值纵向、环向应变及应变率,并于急性期获取实验室参数,包括C反应蛋白(CRP)浓度、红细胞沉降率(ESR)、白细胞(WBC)计数、血小板(PLT)计数、丙氨酸转氨酶(ALT)浓度、天冬氨酸转氨酶(AST)浓度。比较不同时期KD患儿与对照组患儿常规超声心动图参数、左心室局部及整体应变及应变率;比较冠状动脉扩张组与冠状动脉正常组KD患儿常规超声心动图参数、左心室局部及整体应变及应变率;分析急性期KD患儿左心室GLS与常规超声心动图参数及实验室指标的相关性。结果与对照组患儿比较,KD组患儿急性期左心室质量指数(LVMI)、左冠状动脉(LCA)内径、右冠状动脉(RCA)内径均升高,GLS、基底段纵向应变、中间段纵向应变、GCS及基底段环向应变均降低,且差异均有统计学意义(t=4.823、4.123、3.018、3.982、5.135、4.753、3.012、4.6351,P <0.01或0.05);亚急性期KD患儿LVMI、LCA内径仍较高,GLS及中间段纵向应变开始升高但仍较低,且差异均有统计学意义(t=4.786、4.387、4.895、4.031,P <0.01)。与KD患儿急性期比较,KD患儿亚ObjectiveTo assess the change of regional and global left ventricular （LV） myocardial systolic function in patients with Kawasaki disease （KD） in different phases by two-dimensional speckle tracking imaging （2DSTI） and analyze the correlation of systolic peak strain （S） and strain rate （SR） of LV with other conventional indices. Methods50 KD children in acute phase were enrolled as KD group, while 30 age and gender-matched children who had no cardiac abnormalities on echocardiography were included as control group from January 2016 to December 2016 in children hospital of Lanzhou university second hospital. The KD group were divided into coronary artery dilation （CAD） subgroup （n=12） and coronary artery normal （CAN） subgroup （n=38）. Conventional echocardiography parameters, peak systolic LV myocardial regional and global S and SR were obtained using 2DSTI before intravenous immunoglobulin （IVIG） in the acute phase, 1 week after IVIG in the subacute phase, and 8 weeks after the onset of KD in theconvalescent phase. The laboratory parameters including C-reactive protein （CRP）, erythrocyte sedimentation rate （ESR）, white blood cell （WBC）, platelet （PLT）, alanine transaminase （ALT） and aspartatetransaminase （AST） were also acquired from KD patients in acute phase. The Comparisons on above parameters were made between controls and the KD group in different phases, and between CAD subgroup and CAN subgroup as well. The correlation of LV systolic global longitudinal strain （GLS） with conventional echocardiography parameters and laboratory parameters was analyzed. ResultsCompared with controls, The KD group had higher left ventricular mass index （LVMI）, left coronary artery （LCA） diameter, right coronary artery （RCA） diameter and lower GLS, basal longitudinal S, middle longitudinal S, peak systolic global circumferential strain （GCS） and basal circumferential S （t=4.823, 4.123, 3.018, 3.982, 5.135, 4.753, 3.012, 4.6351 respectively, P

关 键 词：超声心动描记术 二维斑点追踪技术 黏膜皮肤淋巴结综合征 心室功能 左 

分 类 号：R540.45[医药卫生—心血管疾病] R725.4[医药卫生—内科学]