超声二维斑点追踪分层应变评价潜水员水肺潜水后左心室收缩功能改变  

Two-dimensional layer-specific strain in evaluation on left ventricular systolic function changes in divers after scuba diving

作　　者：钱胜利[1] 杨莉[1] 刘畅 李延[1] 高菡静[1] 梅枭雄 QIAN Shengli;YANG Li;LIU Chang;LI Yan;GAO Hanjing;MEI Xiaoxiong(Department of Special Diagnosis,Chinese PLA 161 Hospital,Wuhan 430010,China)

机构地区：[1]中国人民解放军第161医院特诊科,湖北武汉430010

出　　处：《中国医学影像技术》2018年第10期1484-1489,共6页Chinese Journal of Medical Imaging Technology

基　　金：解放军超声医学专业委员会科研激励基金(JLJJ2016-005)

摘　　要：目的应用超声二维斑点追踪分层应变技术评估潜水员水肺潜水后左心室收缩功能的改变。方法对60名健康潜水员于潜水前及潜水(佩戴自携式水下呼吸器恒温潜水11m、60min)后即刻、1天、3天分别测量心率(HR)、血压、血氧饱和度(SaO_2);以常规超声心动图获得左心室舒张末容积(LVEDV)、左心室收缩末容积(LVESV)、心输出量(CO)、左心室射血分数(LVEF);以二维分层应变技术获得左心室心内膜下、中层、心外膜下心肌整体纵向应变(GLS_(endo)、GLS_(mid)、GLS_(epi))及整体圆周应变(GCS_(endo)、GCS_(mid)、GCS_(epi))。比较潜水前后各指标的差异。结果潜水前、潜水后即刻、1天、3天,GLS_(epi)、GCS_(mid)、GCS_(epi)、收缩压(SBP)、SaO_2、LVEDV、LVESV和LVEF总体差异无统计学意义(P均>0.05)。与潜水前比较,潜水后即刻舒张压(DBP)升高,HR、CO、GLS_(endo)、GLS_(mid)、GCS_(endo)减低(P均<0.05);潜水后1天DBP恢复至潜水前水平(P>0.05),HR、CO、GLS_(endo)、GLS_(mid)、GCS_(endo)仍减低(P均<0.05);潜水后3天各指标均恢复至潜水前水平(P均>0.05)。结论恒温水肺潜水11m、60min后潜水员左心室收缩功能短期内可发生细微改变;超声二维分层应变技术可敏感检出此改变。Objective To assess the changes of left ventricular systolic function in divers after scuba diving with two-dimensional layer-specific strain technique.Methods The heart rate(HR),blood pressure and oxygen saturation(SaO 2)were measured in 60 healthy divers before and immediately,1 day,3 days after scuba diving(constant temperature diving 11 m and 60 min)respectively.The left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),cardiac output(CO)and left ventricular ejection fraction(LVEF)were obtained with conventional echocardiography.The global longitudinal strain(GLS)of endocardial,midcardial and epicardial layers(GLS endo,GLS mid,GLS epi)and global circumferential strain(GCS)of endocardial,midcardial and epicardial layers(GCS endo,GCS mid,GCS epi)were obtained with two-dimensional layer-specific strain technique.The differences of all the parameters before and after scuba diving were compared.Results There was no significant difference of GLS epi,GCS mid,GCS epi,systolic blood pressure(SBP),SaO 2,LVEDV,LVESV nor LVEF before and immediately,1 day,3 days after scuba diving(all P>0.05).Compared with the results before scuba diving,the diastolic blood pressure(DBP)increased,while HR,CO,GLS endo,GLS mid,GCS endo decreased(all P<0.05)immediately after scuba diving.One day later,DBP restored to the pre-dive level(P>0.05),while HR,CO,GLS endo,GLS mid,GCS endo still showed a decrease(all P<0.05).After 3 days,all the parameters restored to the pre-dive level(all P>0.05).Conclusion After 11 m and 60 min scuba constant temperature diving,the left ventricular systolic function of divers changed slightly,and the two-dimensional layer-specific strain technique could detect the slight changes sensitively.

关 键 词：超声心动描记术 潜水 斑点追踪 分层应变 心室功能 左 

分 类 号：R331.31[医药卫生—人体生理学] R540.45[医药卫生—基础医学]