峰值应变离散度评价肝硬化患者左心室收缩同步性  

Evaluation of Left Ventricular Systolic Synchrony in Patients with Liver Cirrhosis by Peak Strain Dispersion

作　　者：张瑶[1] 杨学平[1] 王雪梅 王江涛 王连双[1] 殷志勇[1] Zhang Yao;Yang Xueping;Wang Xuemei;Wang Jiangtao;Wang Lianshuang;Yin Zhiyong(Department of Ultrasound,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;GE Clinical Education Team,Beijing 100176,China)

机构地区：[1]首都医科大学附属北京地坛医院超声科,北京市100015 [2]首都医科大学附属北京地坛医院通用电气医疗心血管超声临床科研部,北京市100015

出　　处：《中国超声医学杂志》2020年第4期339-342,共4页Chinese Journal of Ultrasound in Medicine

基　　金：首都医科大学附属北京地坛医院院内科研基金“启航计划”项目(No.DTQH201810)。

摘　　要：目的探讨峰值应变离散度(PSD)评价肝硬化患者左心室收缩同步性的临床应用价值。方法入选肝硬化患者60例(根据肝硬化Child-Pugh分级,其中Child-Pugh A级患者16例,Child-Pugh B级患者29例,Child-Pugh C级患者15例),健康对照组60例。在静息状态下超声心动图测量左心功能及形态参数如下:左心室峰值应变离散度(PSD)、左心室长轴整体应变峰值(GLS)、左心室射血分数(EF)、左心室舒张末期内径(LVDd)、左心室收缩末期内径(LVDs)、左房内径(前后径、上下径、左右径)、室间隔厚度等。比较肝硬化组与对照组间以及肝硬化组内不同分级间PSD的差异,并分析PSD的相关性因素。结果(1)与对照组相比,静息状态下肝硬化组的PSD增加(P<0.05),且以Child-Pugh C级增加最为明显(P<0.05);(2)肝硬化组PSD与左房前后径、室间隔厚度相关(r=0.28,P<0.05;r=0.26,P<0.05)。结论肝硬化患者左室峰值应变离散度增加,Child-Pugh C级患者增加更显著,PSD可以作为评价肝硬化患者左心室收缩同步性的指标。Objective This paper aims to study the clinical instructive value of peak strain dispersion(PSD)in assessing the left ventricular systolic synchrony in patients with liver cirrhosis.Methods One hundred and twenty subjects were selected and divided into two groups,with 60patients with liver cirrhosis(16with Child-Pugh Grade,29with Child-Pugh B and 15with Child-Pugh C)in cirrhosis group and the rest in the control group.The values of left ventricular functions measured at resting state using echocardiography are ventricular peak strain dispersion(PSD),left ventricular global longitudinal strain(GLS),left ventricular ejection fraction(EF),left ventricular end diastolic internal diameter(LVDd),left ventricular end-systolic diameter(LVDs),left atrial diameter(anterior-posterior diameter,superior-inferior diameter,transverse diameter),and interventricular septum thickness.The values of PSD between the two groups and the values in cirrhosis group with different Child-Pugh were compared,and the correlation of PSD is was also analyzed.Results Compared with the control group,the PSD in the cirrhosis group increased at resting state(P<0.05),especially for the patients with Child-Pugh C(P<0.05).The PSD in cirrhosis group was correlated with the left atrial anterior-posterior diameter and theinterventricular septum thickness(r=0.28,P<0.05,r=0.26,P<0.05).Conclusions The left ventricular peak strain dispersion increased in patients with liver cirrhosis,especially for those with Child-Pugh C,and PSD is positively correlated with left atrial anterior-posterior diameter and interventricular septum thickness,which could be used to assess the left ventricular systolic synchrony.

关 键 词：峰值应变离散度 斑点追踪 肝硬化 左心室 同步性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.2[医药卫生—诊断学]