二维斑点追踪技术评价心房颤动患者心房机械功能研究  

Assessment of atrial mechanic function and synchrony in patients with paroxysmal atrial fibrillation without left atrium enlargement by 2D speckle tracking echocardiography

作　　者：焦晓芳 周微微[1] 李阳 李雪[1] 张婷婷[1] 王艳秋 王美一 JIAO Xiao-fang;ZHOU Wei-wei;LI Yang;LI Xue;ZHANG Ting-ting;WANG Yan-qiu;WANG Mei-yi(Department of Cardiology,The General Hospital of Shenyang Military Command,Shenyang 110016,China)

机构地区：[1]沈阳军区总医院心血管内科,辽宁沈阳110016

出　　处：《临床军医杂志》2018年第10期1172-1174,共3页Clinical Journal of Medical Officers

基　　金：辽宁省自然科学基金课题(201602778);辽宁省自然科学基金(20180550235)

摘　　要：目的探讨二维斑点追踪技术评价心房无扩大的心房颤动患者心房机械功能的价值。方法选择自2017年1月至2018年2月沈阳军区总医院心血管内科收治的60例PAF患者为研究对象,设为PAF组,另选取40例同期体检健康者为健康组。常规超声测量心功能参数,二维斑点追踪技术测量左心室收缩期应变及应变率(LA_(S-S),LA_(SR-S))、左心房收缩期应变及应变率(LA_(S-A),LA_(SR-A))、右心房心室收缩期应变(RAS-S)、心房收缩期应变(RA_(S-A))。测量左心房整体达峰值应变时间,测量并比较两组各个节段达峰时间的标准差,LA_(S-S)达峰时间标准差记录为SDs,LA_(S-A)达峰时间标准差记录为SDa。结果与健康组比较,PAF组的E/E'显著增加,左心房总排空分数(LATEF)、A'显著降低,差异均有统计学意义(P<0.05)。PAF组的LA_(S-S)、LA_(S-A)、LA_(SR-S)、LA_(SR-A)、RA_(S-S)、RA_(S-A)较健康组显著减低,SDs、SDa显著大于健康组,差异均有统计学意义(P<0.05)。结论二维斑点追踪技术可以早期检测出心脏未出现形态学改变的PAF患者心房功能变化,为临床早期干预提供依据,为患者预后打下基础。Objective To investigate the changes of atrium function in patients with paroxysmal atrial fibrillation(PAF)without left atrium enlargement using two-dimensional speckle tracking echocardiography(STE).Methods A retrospective study was performed on 60 cases of patients with PAF(PAF group)and 40 cases of healthy volunteers(control group)who were admitted from January 2017 to February 2018.Conventional ultrasonography was used to measure cardiac function parameters,and two-dimensional spot tracking technology was used to measure left ventricular systolic strain and strain rate(LA S-S,LA SR-S),left atrial systolic strain and strain rate(LA S-A,LA SR-A),right atrial ventricular systolic strain(RA S-S),and atrial systolic strain(RA S-A).The overall peak strain time of left atrium was measured and compared with the standard deviation of each segment peak time of the two groups.The standard deviation of LA S-S peak time was recorded as SDs and LA S-A peak time was recorded as SDa.Results Compared with the control group,E/E′in the PAF group increased significantly,LATEF and A′reduced significantly,and the difference was statistically significant(P<0.05).LA S-S,LA S-A,LA SR-S,LA SR-A,RA S-S and RA S-A in PAF group were significantly lower than those in the control group,and SDs and SDa were significantly higher than those in the control group,with statistically significant differences(P<0.05).Conclusion The 2D-STE may detect LA dysfunction and dyssynchrony in LAF patients without LA enlargement.STE derived SDs and SDa are powerful parameters for identifying PAF patients,which provides a basis for early clinical intervention and lays a foundation for patients′prognosis.

关 键 词：二维斑点追踪技术 心房颤动 心房功能 

分 类 号：R540.45[医药卫生—心血管疾病] R541.75[医药卫生—内科学]