三维斑点追踪成像评价腹膜透析患者左心室收缩功能及同步性  

Left Ventricular Systolic Function and Synchronization in Peritoneal Dialysis Patients by Three-Dimensional Speckle Tracking Imaging

作　　者：刘畅 范莉 颜紫宁 黄俊 宋香廷 崔灵 LIU Chang;FAN Li;YAN Zining;HUANG Jun;SONG Xiangting;CUI Ling(Department of Echocardiography,the Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University,Changzhou 213003,China)

机构地区：[1]南京医科大学附属常州第二人民医院心超室,江苏常州213003

出　　处：《中国医学影像学杂志》2020年第10期751-756,共6页Chinese Journal of Medical Imaging

基　　金：常州市卫生计生委重大科技项目(ZD201605)。

摘　　要：目的探讨三维斑点追踪成像(3D-STI)评价腹膜透析(PD)患者左心室收缩功能及同步性的价值。资料与方法选择34例PD患者与35例健康人(对照组)进行研究,采集受试者二维及三维超声心动图图像导入斑点追踪软件进行分析,得到二维左心室整体纵向应变(2DGLS)、三维左心室整体面积应变(3DGAS)、整体纵向应变(3DGLS)、整体环向应变(3DGCS)、整体径向应变(3DGRS)及左心室射血分数(3DLVEF),并得到左心室16节段纵向应变达峰时间(TTP)及三维纵向应变达峰时间标准差(Tls-16SD-3D),比较两组间各参数的差异。绘制受试者工作特征曲线,评价2DGLS与3DGLS对PD患者左心室收缩功能异常的检验效能。结果两组3DGRS、3DGCS、3DLVEF差异无统计学意义(P>0.05),PD组2DGLS、3DGLS、3DGAS均低于对照组(P<0.05)。PD组左心室16节段TTP均高于对照组,且大部分节段TTP及Tls-16SD-3D差异有统计学意义(P<0.05)。PD组2DGLS、3DGLS诊断左心室收缩功能异常的曲线下面积分别为0.87和0.92。结论尽管PD患者LVEF在正常范围,但其仍然存在左心室心肌收缩功能及同步性异常,表现为3DGLS、3DGAS下降,TTP及Tls-16SD-3D延长,利用3D-STI可以有效地评估PD患者心脏功能的改变。Purpose To explore the application value of three-dimensional speckle tracking imaging(3D-STI)in evaluating left ventricular(LV)systolic function and synchronization in patients with peritoneal dialysis(PD).Materials and Methods Thirty-four PD patients and 35 control groups were selected for study.Two-dimensional and three-dimensional echocardiographic images of subjects were collected and imported into spot tracking software for analysis.LV two-dimensional global longitudinal strain(2DGLS),three-dimensional global longitudinal strain(3DGLS),global area strain(3DGAS),global circumferential strain(3DGCS)and global radial strain(3DGRS),LV ejection fraction(3DLVEF),LV 16 segment time to peak longitudinal strain(TTP)and the standard deviation of three-dimensional TTP(Tls-16 SD-3D)were obtained,the difference in the above parameters between the two groups were compared.ROC curve was drawn to evaluate the efficacy of 2DGLS and 3DGLS in detecting abnormal left ventricular systolic function in PD patients.Results There were no statistically significant differences in 3DGRS,3DGCS and 3DLVEF between the two groups(P>0.05),while PD patients’2DGLS,3DGLS and 3DGAS were lower than those in the control group(P<0.05).The 16-segment TTP in the left ventricle of PD group was higher than that in the control group,most of the segment TTP and Tls-16 SD-3D differences were statistically significant(P<0.05).The area under curve of 2DGLS and 3DGLS diagnosed abnormal left ventricular systolic function in PD patients was 0.87 and 0.92,respectively.Conclusion Although the LVEF of PD patients is within the normal range,there are still left ventricular myocardial systolic function and synchronization abnormalities,which are manifested as 3DGLS and 3DGAS decline,TTP and TLS-16 SD-3D extension.3D-STI can effectively evaluate the changes of cardiac function in PD patients.

关 键 词：腹膜透析 超声心动描记术 超声心动描记术 三维 斑点追踪成像 心室功能 左 心肌收缩 

分 类 号：R445.1[医药卫生—影像医学与核医学] R459.5[医药卫生—诊断学]