压力-应变环定量评价乙型肝炎肝硬化患者左室整体心肌做功  

Quantitative evaluation of global left ventricular myocardial work in patients with hepatitis B cirrhosis by pressure-strain loop

作　　者：张辉辉 朱好辉 张喜君 李思靓 张苗 李帅[1] 郭雯[1] 孙硕文 袁建军 Zhang Huihui;Zhu Haohui;Zhang Xijun;Li Siliang;Zhang Miao;Li Shuai;Guo Wen;Sun Shuowen;Yuan Jianjun(Department of Echocardiography,Henan University People's Hospital,Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]河南大学人民医院河南省人民医院超声科,郑州450003

出　　处：《中华肝脏病杂志》2022年第4期402-406,共5页Chinese Journal of Hepatology

基　　金：2020年度河南省科技厅河南省科技攻关项目(212102310652)。

摘　　要：目的应用左室压力-应变环对乙型肝炎肝硬化患者左室心肌做功进行定量评估。方法选取2020年3月至12月在河南省人民医院住院的乙型肝炎肝硬化患者70例做为研究组,根据肝硬化Child-Pugh评分分级,患者分为3个亚组,Child-Pugh A级组患者25例;Child-Pugh B级组患者25例;Child-Pugh C级组患者20例;同期纳入25例健康志愿者作为对照组。应用压力-应变环获取心肌整体纵向应变(GLS)、整体做功指数、整体做功效率(GWE)、整体有用功、整体无用功(GWW),分析比较4组间各参数的差异。结果与对照组相比,Child-Pugh A级组GLS降低,Child-Pugh B级组及C级组GLS、GWE、整体做功指数及整体有用功均降低,GWW增高,差异均有统计学意义(P<0.05);与Child-Pugh A级组相比,Child-Pugh B级组GLS、GWE降低,GWW增高,Child-Pugh C级组GLS、GWE、整体做功指数及整体有用功均降低,GWW增高,差异均有统计学意义(P<0.05);与Child-Pugh B级组相比,Child-Pugh C级组GLS、GWE、整体做功指数及整体有用功均降低,GWW增高,差异均有统计学意义(P<0.05)。结论压力-应变环可早期发现乙型肝炎肝硬化患者心肌功能障碍,对乙型肝炎肝硬化患者心肌功能改变的诊疗及预后评价有一定的价值。Objective To quantitatively evaluate myocardial work in patients with hepatitis B cirrhosis by using left ventricular pressure-strain loop.Methods 70 cases with hepatitis B cirrhosis who were hospitalized in Henan Provincial People's Hospital from March to December 2020 were selected as the study group.Patients were divided into three subgroups according to the Child-Pugh score of liver cirrhosis(Child-Pugh class A,B,and C groups:25,25,and 20 patients,respectively).At the same time,25 healthy volunteers were included as the control group.Global longitudinal strain(GLS),global myocardial work index(GWI),global work efficiency(GWE),global constructive work(GCW),and global wasted work(GWW)were obtained by applying pressure-strain loops.The differences were analyzed and compared among the four groups parameters.Results Compared with the control group,the Child-Pugh class A group had decreased GLS,while Child-Pugh class B and C had decreased GLS,GWI,GWE,GCW,and increased GWW,and the differences were statistically significant(P<0.05).Compared with Child-Pugh class A group,Child-Pugh class B group had decreased GLS,GWE,and increased GWW,while Child-Pugh class C group had decreased GLS,GWI,GWE,GCW,and increased GWW,and the differences were statistically significant(P<0.05).Compared with Child-Pugh class B group,Child-Pugh class C group had decreased GLS,GWI,GWE,GCW,and increased GWW,and the differences were statistically significant(P<0.05).Conclusion The pressure-strain loop can detect early myocardial dysfunction,and has a certain value in the diagnosis,treatment and prognosis evaluation of myocardial function changes in patients with hepatitis B cirrhosis.

关 键 词：肝硬化 心肌做功 压力-应变环 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]