二维斑点追踪技术及血清学参数评估肝硬化患者右心室功能  

Assessment of the right ventricular function in patients with liver cirrhosis using 2DSpeckle Tracking Imaging and serological parameters

作　　者：吴珊[1] 张卫平[1] 王健[2] 李媛 朱剑芳[1] WU Shan;ZHANG Wei-ping;WANG Jian;LI Yuan;ZHU Jian-fang(Department of Ultrasonography,the First Affiliated Hospital of Nanchang University,330000 Nanchang,China;Department of Gastroenterology,the First Affiliated Hospital of Nanchang University,330000 Nanchang,China)

机构地区：[1]南昌大学第一附属医院超声医学科,江西南昌330000 [2]南昌大学第一附属医院消化内科,江西南昌330000

出　　处：《临床消化病杂志》2020年第5期312-315,共4页Chinese Journal of Clinical Gastroenterology

摘　　要：[目的]运用二维斑点追踪技术(2D-STI)评价肝硬化患者右心室功能,结合血清学参数,探讨评价肝硬化性心肌病的检测方法。[方法]检测60例肝硬化患者和20例健康体检者(正常对照组)血清学参数包括肌钙蛋白(cTnI)、肌酸激酶同工酶(CK-MB)及N末端-B型利钠肽(NT-proBNP)。依据肝功能Child-Pugh分级将60例肝硬化患者分为Child A级组(A组,23例)、Child B级组(B组,20例)、Child C级组(C组,17例),应用2D-STI测量各组右心室游离壁收缩期峰值应变(S)、收缩期峰值应变率(SRs)、舒张早期峰值应变率(SRe)、舒张晚期峰值应变率(SRa)。[结果](1)各组心脏血清学测值比较:C组NT-proBNP与其他各组比较均差异有统计学意义,B组NT-proBNP与正常对照组、A组比较差异有统计学意义;(2)各组右心室常规测量参数比较:C组中右心房内径、三尖瓣环舒张早期心肌运动速度(Em)、三尖瓣舒张早期峰值速度/Em、三尖瓣环收缩期位移与各组比较均差异有统计学意义,B组RA、TAPSE与正常对照组比较差异有统计学意义;(3)各组右心室游离壁心肌病变及应变率参数比较:C组S、SRe、SRa与各组比较均差异有统计学意义,C组SRs与正常对照组、A组比较差异有统计学意义,B组各参数与正常对照组、A组比较均差异有统计学意义。A组各参数与正常对照组比较均差异无统计学意义(P>0.05)。[结论]2D-STI联合血清CK-MB、NT-proBNP指标能有效评估肝硬化患者右心室功能,是一种简便、可靠的检测方法。[Objective]To discuss the method feasibility that evaluating combined the right ventricle function of cirrhosis patiens by using 2 D-STI combined with serological parameters.[Methods]Serological parameters of 60 patients with cirrhosis and 20 health checkers were tested,including troponin(cTnI),creatine kinase lsoenzyme(CK-MB)and N-terminal pro-brian natriuretic peptide(NT-proBNP).According to the Child-Pugh grading standard,patients with cirrhosis were divided into grade Child A group(23 cases),grade Child B group(20 cases)and grade Child C group(17 cases).2 D-STI was used to detect the right ventricular free wall of the peak strain in systolic(S),the peak strain rate in systolic(SRs),the peak strain rate in early diastole(SRe),and peak strain rate in atrial contraction(SRa).[Results]The values of CK-MB and NT-proBNP in Child C group were significantly higher than those in control group and Child A group(P<0.05).The S,SRs,SRe in grade Child B and grade Child C were significantly lower than the normal control group and grade Child A.The S,SRe in grade Child C compared with grade Child B,the difference was statistically significant(P<0.05).The SRa in grade Child B and grade Child C was significantly higher than normal control group and grade Child A.The SRa in grade Child C compared with grade Child B,the difference was statistically significant(P<0.05).The all parameters between grade Child A and the normal control group were no significant different.[Conclusion]2 D-STI combined with CK-MB,NT-proBNP is a simple and reliable detection method in evaluating the right ventricular function of patients with cirrhosis.

关 键 词：肝硬化 右心室功能 二维斑点追踪技术 血清学 

分 类 号：R575.2[医药卫生—消化系统]