二维斑点追踪技术评价房间隔缺损封堵术后右心室功能的改善效果  

Evaluation of improvement of right ventricular function after atrial septal defect occlusion by two-dimensional speckle tracking

作　　者：董静[1] 张俊霞[2] 周陵[2] 冉红[1] 吴文芳[1] 方玲玲[1] 张平洋[1] DONG Jing;ZHANG Junxia;ZHOU Ling;RAN Hong;WU Wenfang;FANG Lingling;ZHANG Pingyang(Department of Cardiovascular Ultrasound,Nanjing Hospital Affiliated to Nanjing Medical University/Nanjing First Hospital,Jiangsu Province,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院/南京市第一医院心血管超声科,210006 [2]南京医科大学附属南京医院/南京市第一医院心内科,210006

出　　处：《疑难病杂志》2019年第12期1200-1203,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：国家自然科学基金资助项目(81700398)

摘　　要：目的采用二维斑点追踪技术(2D-STI)评价房间隔缺损(ASD)封堵术后右心室功能的改善效果。方法选取2017年3月-2018年12月于南京医科大学附属南京医院/南京市第一医院心内科行房间隔缺损封堵术患者44例作为观察组,采用2D-STI测量ASD患者于封堵术前、术后3 d右心室各段的收缩峰值纵向应变(PSLS)及其应变率、运动速度变化情况,同时观察患者手术前、后的心功能变化。纳入同期36例性别及年龄匹配的健康正常人作为健康对照组。结果与健康对照组比较,观察组术前RVEDV、RVESV水平明显升高(P<0.01),而LVEDV、LVESV水平明显降低(P<0.05或P <0.01);观察组术后3 d的RVEDV、RVESV水平明显低于术前,而LVEDV、LVESV水平高于术前,差异均有统计学意义(P<0.01)。观察组术前右心室游离壁基底段、中间段、心尖段的应变、速度及应变率均高于健康对照组(P<0.01),观察组患者术前右心室间隔基底段、心尖段的应变、速度及应变率也明显高于健康对照组(P <0.01)。与术前比较,观察组患者术后3 d右心室游离壁各段、右心室间隔基底段与心尖段的应变、速度及应变率降低(P <0.01),而右心室间隔中间段的应变、速度及应变率差异均无统计学意义(P>0.05)。结论房间隔缺损封堵术可以改善ASD患者术后短期右心室功能,2D-STI能够准确检测及评价ASD患者术后右心功能改善情况。Objective To evaluate improvement effect of right cardiac function after atrial septal defect(ASD) occlusion by two dimensional speckle tracking imaging(2D-STI).Methods From March 2017 to December 2018,44 patients with atrial septal defect occlusion in the Department of Cardiology,Nanjing Hospital,Nanjing Medical University/Nanjing First Hospital were selected as the observation group.The 2D-STI was used to measure the peak longitudinal contraction strain(PSLS),the strain rate and the speed of movement of each segment of the right ventricle before and 3 days after occlusion.At the same time,patients’ cardiac function changes were observed before and after surgery.Thirty-six gender-and age-matched healthy subjects were included as healthy controls.Results Compared with the control group,the levels of RVEDV and RVESV in the observation group increased significantly before surgery(P <0.01),while the levels of LVEDV and LVESV decreased significantly(P <0.05 or P <0.01).In the observation group,the levels of RVEDV and RVESV at 3 days after surgery were significantly lower than those before surgery,while the levels of LVEDV and LVESV were higher than before surgery,the differences were statistically significant(P <0.01).In the observation group,the strain,velocity and strain rate of the free wall basal,middle and apical segments of the right ventricle before operation were higher than those in the control group(P<0.01).Strains,velocities,and strain rates of the right ventricular septal basal and apical segments in the observation group were significantly higher than those in the control group(P <0.01).Compared with the preoperative group,the strain,velocity and strain rate of the right ventricular free wall segment,right ventricular septum basal segment and apical segment were decreased in the observation group 3 days after surgery(P <0.01).There was no statistically significant difference in the strain,velocity,and strain rate of the right ventricular septum(P>0.05).Conclusion Atrial septal defect closure can improv

关 键 词：房间隔缺损 二维斑点追踪技术 右心室功能 

分 类 号：R54[医药卫生—心血管疾病]