三维超声斑点追踪技术联合Z值精准分析扩张型心肌病病儿心肌沿长轴运动特点  

PRECISE EVALUATION OF MYOCARDIAL LONGITUDINAL STRAIN IN CHILDREN WITH DILATED CARDIOMYOPATHY USING THREE-DIMENSIONAL SPECKLE TRACKING ECHOCARDIOGRAPHY COMBINED WITH Z SCORE

作　　者：丛娟[1] 李自普 王吴刚[1] 付秀秀[1] 孟媛媛[1] 李俊芳[1] 何香芹[1] 李勇[1] 王志斌[1] CONG Juan;LI Zipu;WANG Wugang;FU Xiuxiu;MENG Yuanyuan;LI Junfang;HE Xiangqin;LI Yong;WANG Zhibin(Department of Echocardiography,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院心脏超声科,山东青岛266003 [2]青岛市妇女儿童医院心脏中心

出　　处：《精准医学杂志》2018年第5期403-406,共4页Journal of Precision Medicine

基　　金：青岛市医疗卫生优秀人才培养项目资助(青卫科教字[2017]4号)

摘　　要：目的三维超声斑点追踪技术联合Z值精准分析扩张型心肌病(DCM)病儿左心室心肌沿长轴运动特点。方法利用三维超声斑点追踪技术对25例DCM及30例正常儿童进行心脏超声检测;脱机分析心脏三维容积数据,获得16节段及整体心肌长轴应变(GLS)以及左心室舒张末容积(EDV)、左心室收缩末容积(ESV)及左心室射血分数(LVEF)等参数,并与改良Ross标准对照,同时与左心室舒张末内径Z值进行相关性分析。结果病儿左心室GLS及16节段心肌长轴应变较对照组显著降低(t=17.79,P<0.05)。随着心力衰竭程度逐渐加重,病儿心肌长轴应变逐渐降低(F=14.47,P<0.05);DCM病儿的无心力衰竭组GLS较正常儿童组显著降低(t=-5.07,P<0.05);而两组间LVEF比较差异无显著性(P>0.05)。GLS与左心室舒张末内径Z值呈显著负相关(r=-0.915,P<0.01)。结论三维超声斑点追踪技术联合Z值能够精准反映DCM病儿左心室心肌沿长轴运动的能力随心衰程度加重而减低的特点。Objective To investigate the features of global longitudinal strain(GLS)in children with dilated cardiomyo-pathy(DCM)using three-dimensional speckle tracking echocardiography(3D STE)combined with Z score. Methods 3D STE was performed for 25 children with DCM and 30 normal children.Three-dimensional volumetric data of the heart were analyzed offline to obtain related parameters including GLS and longitudinal strain of the 16 segments of the myocardium,left ventricular end-diastolic volume,left ventricular end-systolic volume,and left ventricular ejection fraction(LVEF).These parameters were compared with the modified Ross score,and their correlation with the Z score of left ventricular end-diastolic diameter was analyzed.Results Compared with the control group,the DCM group had significant reductions in GLS of the left ventricle and longitudinal strain of the 16 segments of the myocardium(t=17.79,P<0.05).Longitudinal strain of the myocardium gradually decreased with the increase in the severity of heart failure(F=14.47,P<0.05);compared with the control group,the non-heart failure DCM group had a significant reduction in GLS(t=-5.07,P<0.05),while there was no significant difference in LVEF between the two groups(P>0.05).GLS was negatively correlated with the Z score of left ventricular end-diastolic diameter(r=-0.915,P<0.01). Conclusion 3D STE combined with Z score can precisely reflect that in children with DCM,the longitudinal strain of the left ventricle decreases with the increase in the severity of heart failure.

关 键 词：超声心动描记术 三维 心肌病 扩张型 心室 心肌 儿童 

分 类 号：R725.422[医药卫生—儿科] R445.1[医药卫生—临床医学]