三维斑点追踪技术评价缺血性心肌病患者左心室收缩功能及与血清N末端脑利钠肽前体水平的关系  

Evaluation of Left Ventricular Systolic Function in Patients with Ischemic Cardiomyopathy by Three-dimensional Speckle Tracking Imaging and its Relationship with the Serum NT-proBNP Level

作　　者：林文海[1] 叶庭芳 吴德礼 LIN Wenhai;YE Tingfang;WU Deli(Shenzhen Luohu District People's Hospital / Shenzhen Fifth People's Hospital,Guangdong Shenzhen 518100,China)

机构地区：[1]广东省深圳市罗湖区人民医院/深圳市第五人民医院

出　　处：《河北医学》2019年第7期1091-1095,共5页Hebei Medicine

基　　金：广东省科技计划项目,(编号:2017ZC12078)

摘　　要：目的:探究三维斑点追踪技术(3D-STI)对缺血性心肌病(ICM)患者左心室收缩功能的评价及ICM患者左心室收缩功能与N末端脑利钠肽前体(NT-proBNP)水平的关系。方法:选取2015年2月至2018年2月我院确诊的ICM患者52例为观察组,同时选取30例健康志愿者作为对照组。采用3D-STI获取两组研究对象左心室三维全容积动态图像,通过工作站行脱机分析,计算左心室整体纵向应变(GLS)、左心室整体圆周应变(GCS)、左心室整体径向应变(GRS)及左心室整体应变(GS),并对比两组间差异。采用光化学法检测两组研究对象的NT-proBNP水平并分析观察组患者左心室收缩功能与NT-proBNP的关系。结果:观察组GLS、GCS及GS均明显高于对照组(P<0.05),GRS明显低于对照组(P<0.05),而血清NT-proBNP明显高于对照组(P<0.05)。观察组患者GLS、GCS及GS与血清NT-proBNP呈正相关(r=0.416、0.387、0.424,均P<0.05),而GRS与血清NT-proBNP呈负相关(r=-0.496,P<0.05)。结论:3D-STI能较好评价ICM患者左心室收缩功能,值得临床推广。GLS、GCS及GS与血清NT-proBNP呈正相关,GRS与血清NT-proBNP呈负相关,故血清NT-proBNP水平可考虑作为评价ICM患者左心室收缩功能的辅助指标。Objective:To investigate the relationship between left ventricular systolic function in patients with ischemic cardiomyopathy(ICM)evaluated by three-dimensional speckle tracking imaging(3D-STI)and the serum N-terminal pro-brain natriuretic peptide(NT-proBNP)level.Methods:A total of 52 patients with ICM diagnosed in the hospital during the period from February 2015 to February 2018 were selected as the observation group,and 30 healthy volunteers were selected as the control group.The three-dimensional full-volume dynamic images of the left ventricle were obtained by 3D-STI,and they were sent to work station for off-line analysis.The left ventricular global longitudinal strain(GLS),left ventricular global circumferential strain(GCS),left ventricular global radial strain(GRS)and left ventricular global strain(GS)were calculated and compared between the two groups.The NT-proBNPlevels in both groups were measured by photo-chemistry and the relationship between left ventricular systolic function and NT-proBNP level in the observation group was analyzed.Results:GLS,GCS and GS in the observation group were significantly higher than those in the control group(P<0.05),while the GRS was significantly lower than the control group(P<0.05).Serum NT-proBNP levels were significantly higher than those in the control group(P<0.05).GLS,GCS and GS were positively correlated with the serum NT-proBNPlevel in the observation group(r=0.416,0.387,0.424,P<0.05),while GRS was negatively correlated with the serum NT-proBNP level(r=-0.496,P<0.05).Conclusion:3D-STI can better evaluate the left ventricular systolic function in patients with ICM.GLS,GCS and GS are positively correlated with the serum NT-proBNP level,while GRS is negatively correlated with the serum NT-proBNP level.Therefore,the serum NT-proBNP level can be used as an auxiliary index for evaluating the left ventricular systolic function in。

关 键 词：缺血性心肌病 三维斑点追踪技术 左心室收缩功能 N末端脑利钠肽前体 

分 类 号：R542.2[医药卫生—心血管疾病] R445.1[医药卫生—内科学]