实时三维斑点追踪技术评价潜水员水肺潜水后左心室收缩功能改变  

Evaluation of left ventricular systolic function changes in divers after scuba diving by three-dimensional speckle tracking imaging

作　　者：钱胜利[1] 杨莉[1] 杜锐 刘畅[1] 李延[1] 高菡静[1] 梅枭雄 Qian Shengli;Yang Li;Du Rui;Liu Chang;Li Yan;Gao Hanjing;Mei Xiaoxiong(Department of Special Diagnosis,Chinese PLA 161 Hospital,Wuhan 430010,China)

机构地区：[1]中国人民解放军第一六一医院特诊科

出　　处：《中华医学超声杂志（电子版）》2019年第12期937-942,共6页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：解放军超声医学专业委员会科研激励基金(JLJJ2016-005)

摘　　要：目的应用实时三维斑点追踪技术评价潜水员水肺潜水后左心室收缩功能的改变。方法对60例健康潜水员潜水前及佩戴自携式水下呼吸器恒温潜水11 m、60 min后即刻、1 d、3 d分别测量心率、血压[收缩压(SBP)和舒张压(DBP)]、血氧饱和度(SaO2),同时行常规超声心动图检查。应用三维斑点追踪技术分别获取潜水前及潜水后即刻、1 d、3 d左心室舒张末容积(LVEDV)、收缩末容积(LVESV)、心输出量(CO)、左心室射血分数(LVEF)及左心室三维应变参数,包括左心室整体纵向应变(LVGLS)、整体圆周应变(LVGCS)、整体面积应变(LVGAS)、整体径向应变(LVGRS)。比较潜水前后常规参数及左心室三维应变参数差异。结果与潜水前比较,水肺潜水后即刻LVEF无明显改变,SBP、SaO2、LVEDV、LVESV、LVGCS、LVGRS虽稍降低,但差异均无统计学意义,而DBP升高,心率、CO、LVGLS、LVGAS均降低,且差异均有统计学意义(t=-3.13,P=0.007;t=9.609,P<0.001;t=2.597,P=0.020;t=-3.877,P=0.008;t=-15.715,P<0.001);潜水后1 d,DBP已基本恢复至潜水前水平,但心率、CO、LVGLS、LVGAS仍降低,且差异仍均有统计学意义(t=2.772,P=0.021;t=4.116,P=0.001;t=-2.736,P=0.018;t=-10.382,P<0.001);潜水后3 d,上述各指标均恢复至潜水前水平。结论水肺恒温潜水11 m、60 min后潜水员的部分心血管指标会发生短期的细微改变。实时三维斑点追踪技术可发现左心室收缩功能细微改变,其动态定量评估潜水后左心室收缩功能,对指导潜水员进行科学潜水训练具有重要的临床意义。Objective To assess the changes of left ventricular systolic function in divers after scuba diving by three-dimensional tracking imaging.Methods The heart rate(HR),blood pressure[systolic blood pressure(SBP)and diastolic blood pressure(DBP)],and oxygen saturation(SaO2)were measured in 60 healthy divers before,immediately after,and 1 d and 3 d after scuba constant temperature diving to a depth of 11 metres for 60 min,respectively,and conventional echocardiography was performed at the same time.Three-dimensional tracking imaging was applied to obtain the left ventricular diastolic volume(LVEDV),left ventricular systolic volume(LVESV),cardiac output(CO),left ventricular ejection fraction(LVEF),and left ventricular three-dimensional strain parameters including the global longitudinal strain(LVGLS),global circumferential strain(LVGCS),global area strain(LVGAS),and global radial strain(LVGRS)before,immediately after,and 1 d and 3 d after scuba diving.The differences of routine and left ventricular threedimensional strain parameters were compared before and after scuba diving.Results Compared with the parameters before scuba diving,there was no significant change in the LVEF;the SBP,SaO2,LVEDV,LVESV,LVGCS,and LVGRS decreased slightly(with no significant changes);and DBP significantly increased,and the HR,CO,LVGLS,and LVGAS significantly decreased immediately after scuba diving(t=-3.13,P=0.007;t=9.609,P<0.001;t=2.597,P=0.020;t=-3.877,P=0.008;t=-15.715,P<0.001).At 1 d after scuba diving,DBP was restored to the pre-diving level,but the HR,CO,LVGLS,and LVGAS were still significantly lower(t=2.772,P=0.021;t=4.116,P=0.001;t=-2.736,P=0.018;t=-10.382,P<0.001).At 3 d after scuba diving,all the above parameters were recovered to the pre-dive levels.Conclusion After scuba constant temperature diving to a depth of 11 metres for 60 min,some of the cardiovascular indicators of divers change slightly in a short term.Three-dimensional tracking imaging can find the slight changes in left ventricular systolic function and quantitatively

关 键 词：实时三维斑点追踪技术 潜水 心室功能 左 

分 类 号：R540.45[医药卫生—心血管疾病] R84[医药卫生—内科学]