斑点追踪技术评价缩窄性心包炎患者术后左心室旋转及扭转  

Evaluation of left ventricular rotation and twist in patients with constrictive pericarditis after pericardiectomy with speckle tracking echocardiography

作　　者：李礼 邓又斌[1] 刘琨 刘红云[1] 毕小军 Li Li;Deng Youbin;Liu Kun;Liu Hongyun;Bi Xiaojun(Department of Medical Ultrasound,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Medical Ultrasound,Third People′s Hospital of Hubei Province,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院超声影像科,武汉430030 [2]湖北省第三人民医院超声影像科,武汉430030

出　　处：《中华超声影像学杂志》2021年第4期277-281,共5页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金(81701714)。

摘　　要：目的应用斑点追踪技术评价缩窄性心包炎患者心包切除术后左心室旋转及扭转角度,并观察其随时间的变化趋势。方法2014年9月至2017年12月华中科技大学同济医学院附属同济医院29例缩窄性心包炎患者,于心包切除术前1周和术后1个月、6个月、12个月进行超声心动图检查,应用斑点追踪技术测量左室基底部和心尖部峰值旋转角度及左室峰值扭转角度。另选取同期29例正常人作为对照组。结果缩窄性心包炎患者左室心尖部峰值旋转角度[术前(6.62±3.19)°,术后1个月(7.07±4.02)°,术后6个月(7.88±4.46)°,术后12个月(7.85±4.51)°]、左室峰值扭转角度[术前(10.50±4.94)°,术后1个月(9.42±5.40)°,术后6个月(9.59±4.62)°,术后12个月(9.70±4.45)°]较对照组[(11.22±5.17)°,(16.35±5.21)°]显著减低(均P<0.05)。左室基底部峰值旋转角度术后均较对照组显著减低[术后1个月(-3.85±3.20)°,术后6个月(-3.49±2.09)°,术后12个月(-3.53±2.01)°;对照组(-5.57±2.78)°](均P<0.05),而术前[(-5.22±3.14)°]与对照组[(-5.57±2.78)°]差异无统计学意义(P>0.05)。缩窄性心包炎术前、术后各组间比较,左室基底部峰值旋转角度、心尖部峰值旋转角度及左室峰值扭转角度的差异无统计学意义(均P>0.05)。结论缩窄性心包炎术后长期虽然左室整体功能正常,但基底部、心尖部旋转及左室扭转仍较正常人减低。斑点追踪技术可用于评价缩窄性心包炎患者心包切除术后长期左室旋转及扭转功能的改变。Objective To evaluate the left ventricular rotation and twist in patients with constrictive pericarditis(CP)after pericardiectomy by using speckle tracking echocardiography(STE),and observe its trend over time.Methods A total of 29 patients with CP from Department of Medical Ultrasound,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from September 2014 to December 2017 underwent echocardiography 1 week before and 1 month,6 months,12 months after pericardiectomy.STE was performed to obtain peak values of basal and apical rotation and left ventricular twist.Twenty-nine healthy subjects were recruited as controls in the same period.Results The left ventricu1ar apical rotation[before surgery(6.62±3.19)°,1 month after surgery(7.07±4.02)°,6 months after surgery(7.88±4.46)°,12 months after surgery(7.85±4.51)°],the left ventricu1ar twist[before surgery(10.50±4.94)°,1 month after surgery(9.42±5.40)°,6 months after surgery(9.59±4.62)°,12 months after surgery(9.70±4.45)°]were significantly lower in patients with CP than those in controls[(11.22±5.17)°,(16.35±5.21)°](all P<0.05);while basal rotation in patients with CP after surgery among different time points were all significantly lower than those in controls[1 month after surgery(-3.85±3.20)°,6 months after surgery(-3.49±2.09)°,12 months after surgery(-3.53±2.01)°;controls(-5.57±2.78)°](all P<0.05),with no significant difference between patients with CP before surgery(-5.22±3.14)°and controls(-5.57±2.78)°(P>0.05).There were no significant differences in left ventricular twist,basal and apical rotation in CP groups before and after surgery among different time points(all P>0.05).Conclusions Although the left ventricular global function of patients with CP in the long postoperative period seems"normal",the left ventricular twist,basal and apical rotation are still significantly lower than those in controls.STE can be used to assess the changes of left ventricular twist and rotation in patients with CP long

关 键 词：斑点追踪显像 缩窄性心包炎 心包切除术 旋转 扭转 心室功能 左 

分 类 号：R445.1[医药卫生—影像医学与核医学] R654.2[医药卫生—诊断学]