二维斑点追踪成像技术评价系统性硬化病患者右心室收缩功能的应用研究  

Evaluation of Right Ventricular Systolic Function in Patients with Systemic Sclerosis Using Two-dimensional Speckle Tracking Imaging

作　　者：韩光荣 王亚婷 车国英[1] 邸郅欣[1] 田家玮[1] 苏雁欣[1] Han Guangrong;Wang Yating;Che Guoying;Di Zhixin;Tian Jiawei;Su Yanxin(Department of Ultrasound,the Second Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150086,China)

机构地区：[1]哈尔滨医科大学附属第二医院超声医学科

出　　处：《中国超声医学杂志》2019年第6期495-498,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用二维斑点追踪成像(2D-STI)技术评价系统性硬化病(SSc)患者右心室收缩功能。方法选取65例伴有三尖瓣反流的SSc患者,测量三尖瓣反流峰值流速,估测肺动脉压力(SPAP)。按SPAP严重程度将SSc患者分为无肺动脉高压(No-PAH)组,轻度PAH组和中重度PAH组以及对照组。超声心动图检测参数包括:右心室前壁厚度(RVAW)、右心室舒张末期内径(RVDD)、三尖瓣环运动幅度(TAPSE)、右心室面积变化分数(FAC)、右心室射血分数(RVEF)、右心室侧壁纵向收缩峰值应变(RV-LS)、右心室侧壁纵向收缩峰值应变率(RV-LSR)。结果(1)对照组与No-PAH组比较,各参数无统计学差异;轻度PAH组与No-PAH组比较,右室壁整体及各节段纵向峰值应变、整体及中间段、心尖段纵向峰值应变率明显减低(P<0.05);而基底段应变率与对照组无统计学差异。中重度SScPAH组与各组比较,参数均有统计学差异(P<0.01)。(2)2D-STI参数与常规超声参数具有良好相关性(P<0.01)。结论 2D-STI可较早期评估SSc患者右心室收缩功能的减低,为临床的诊断和治疗提供依据。Objective To evaluate right ventricular systolic function in patients with systemic sclerosis(SSc)by two-dimensional speckle tracking imaging(2 D-STI).Methods 65 SSc patients with tricuspid regurgitation were selected.Peak velocity of tricuspid regurgitation(Vmax)was measured for calculating pulmonary arterial systolic pressure(SPAP).According to SPAP,patients were divided into three groups:no pulmonary hypertension(No-PAH)group,mild pulmonary hypertension(PAH)group,moderate or severe PAH group and control group.Echocardiography measure-ment parameters include:right ventricular anterior wall(RVAW),right ventricular end-diastolic diameter(RVDD),tricuspid annular plane systolic excursion(TAPSE),fraction of area change(FAC),right ventricular ejection fraction(RVEF),Right ventricular lateral wall longitudinal peak systolic strain(RV-LS),right ventricular lateral wall longitudinal peak strain rate(RV-LSR).Results(1)The indexes in No-PAH group were not significant with control group.Between the mild PAH group and No-PAH group,global and segmental longitudinal peak systolic of right ventricular wall,as well as longitudinal peak systolic strain rate of global,middle segment,apical were significantly decreased(P<0.05).longitudinal peak systolic strain rate in basal segment were not significantly different from control group.There were significant differences in all parameters between moderate or severe PAH group and other group.(2)The parameters measured by 2 D-STI were positively correlated with PASP(P<0.001).Conclusions 2 D-STI can be used to evaluate the impairment of right ventricular systolic function in patients with SSc at an early stage,which provides evidence for clinical diagnosis and treatment.

关 键 词：斑点追踪成像 系统性硬化病 肺动脉高压 心室功能 右 

分 类 号：R593.2[医药卫生—内科学] R540.45[医药卫生—临床医学]