二维斑点追踪成像技术评价代谢综合征患者亚临床左室收缩及舒张功能异常  

Assessment of two-dimensional speckle tracking imaging in left ventricular systolic and diastolic dysfunction in patients with metabolic syndrome

作　　者：刘慧兰[1] 颜如玉[1] 王佳南 王清木[1] LIU Huilan;YAN Ruyu;WANG Jia’nan;WANG Qingmu(Department of Cardiac Ultrasound,Quanzhou First Hospital Affiliated to Fujian Medical University,Fujian 362000,China)

机构地区：[1]福建医科大学附属泉州第一医院超声心动图室,福建省泉州市362000 [2]福建医科大学附属泉州第一医院心内科,福建省泉州市362000

出　　处：《临床超声医学杂志》2018年第12期798-801,共4页Journal of Clinical Ultrasound in Medicine

基　　金：福建省卫生厅青年科研课题项目(2013-2-125)

摘　　要：目的探讨二维斑点追踪成像(2D-STI)技术评价代谢综合征(MS)患者亚临床左室收缩及舒张功能异常的临床价值。方法选取我院30例MS患者(MS组)和同期年龄与之匹配的30例健康体检者(对照组),测量其常规超声心动图检查指标;同时应用2D-STI技术检测左室整体收缩期纵向和圆周峰值应变、左室心底部及心尖部旋转角度,以及左室峰值扭转速度和解旋速度,计算左室峰值扭转角度和等容舒张期解旋率。比较两组上述各指标差异。结果与对照组比较,MS组左房前后径(LAd)、左室舒张末期内径(LVEDd)、舒张末期室间隔厚度(IVS)及左室后壁厚度(LVPW)、左室质量指数(LVMI)及二尖瓣舒张早期峰值血流速度与二尖瓣环舒张早期运动速度之比(E/e)均明显增大,而二尖瓣舒张早、晚期峰值血流速度之比(E/A)明显减小,差异均有统计学意义(均P<0.01);两组左室射血分数(LVEF)和左室收缩末期内径(LVESd)比较差异均无统计学意义。MS组左室整体收缩期纵向峰值应变和等容舒张期解旋率明显减低,左室峰值扭转角度增大,左室峰值扭转速度和左室峰值解旋速度均明显加快,与对照组比较差异均有统计学意义(均P<0.05);两组左室整体收缩期圆周峰值应变比较差异无统计学意义。结论 MS患者早期即存在左室结构和收缩、舒张功能的改变;2D-STI技术较传统超声心动图能更准确、全面地反映左室心肌早期收缩及舒张功能的变化。Objective To explore the clinical value of two-dimensional speckle tracking imaging(2D-STI)in assessing left ventricular systolic and diastolic dysfunction in patients with metabolic syndrome(MS).Methods Thirty MS patients(MS group)were selected and examined for conventional echocardiography,and 2D-STI was used to measure the left ventricular global peak systolic longitudinal strain(GLS),global peak circumferential strain(GCS),the basal and apical rotation angle,peak twisting and untwisting speed of left ventricular,the twisting angle and untwisting rate were calculated.Another 30 healthy volunteers were enrolled as control.Results Compared with the control,the left anteroposterior diameter,left ventricular end diastolic diameter,end diastolic septal thickness,left ventricular posterior wall thickness,the ratio of left ventricular mass index and early peak systolic blood flow velocity to mitral annulus early diastolic velocity(E/e)of MS group were significantly indreased(all P<0.01),while the ratio of mitral value diastolic early and late peak blood flow velocity(E/A)was significantly decreased(P<0.01).There was no significant difference in left ventricular ejection fraction and left ventricular end systolic diameter between the two groups.Compared with the control,GLS of MS group was significantly reduced,twisting angle of left ventricular was increased,peak twisting and untwisting speed of left ventricular were accelerated(all P<0.05),while untwisting rate of isovolumic diastolic significantly reduced(P<0.05).There was no significant difference of GCS between two groups.Conclusion The left ventricular structure and changes of systolic and diastolic function can be observed in early MS patients.2D-STI technology can accurately and comprehensively reflect in early systolic and diastolic function of left ventricular function in MS patients.

关 键 词：超声心动描记术 斑点追踪成像 二维 代谢综合征 心室功能 左 

分 类 号：R540.45[医药卫生—心血管疾病] R589[医药卫生—内科学]