超声心动图自动心肌运动定量技术评估川崎病患儿左心室收缩功能  

Echocardiographic automatic cardiac motion quantification technique for assessment of left ventricular systolic function in children with Kawasaki disease

作　　者：刘云[1] 耿笑端 栗河舟[1] 李艳[2] 吴娟[1] 张亚鹏 LIU Yun;GENG Xiaoduan;LI Hezhou;LI Yan;WU Juan;ZHANG Yapeng(Department of Ultrasound,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;2.Department of Pediatrics,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院超声科,河南郑州450052 [2]郑州大学第三附属医院儿内科,河南郑州450052

出　　处：《中国医学影像技术》2022年第6期842-847,共6页Chinese Journal of Medical Imaging Technology

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200447)。

摘　　要：目的观察超声心动图自动心肌运动定量(aCMQ)技术评估川崎病(KD)患儿左心室收缩功能的应用价值。方法回顾性分析53例入院后接受常规静脉注射免疫球蛋白(IVIG)治疗的KD患儿(KD组),包括22例冠状动脉扩张(A亚组)、31例冠状动脉未扩张(B亚组);以同期58名健康儿童作为对照组。对KD组分别于治疗前12 h内(急性期)、治疗后1周(亚急性期)及6~10周(恢复期)行超声心动图检查,以M型超声测量左心室常规参数,获得左心室心尖两腔、三腔及四腔观二维动态图像并以QLab 13.0软件进行脱机aCMQ分析,获取左心室局部纵向应变(LS)、整体纵向应变(GLS)及组织运动二尖瓣环位移(TMAD)相关参数。结果急性期KD患儿与健康儿童间,左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)、舒张末期室间隔厚度(IVSD)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)差异均无统计学意义(P均>0.05)。急性期、亚急性期KD患儿基底段LS、中间段LS、心尖段LS、心尖两腔观LS(LS_(AP2))、心尖三腔观LS(LS_(AP3))、心尖四腔观LS(LS_(AP4))、GLS及恢复期基底段LS、LS_(AP4)均较健康儿童降低(P均<0.05);亚急性期、恢复期KD基底段LS、中间段LS、心尖段LS、LS_(AP2)、LS_(AP3)、LS_(AP4)、GLS均较急性期升高(P均<0.05);恢复期中间段LS、心尖段LS、LS_(AP3)、GLS较亚急性期升高(P均<0.05)。急性期A亚组与B亚组左心室LS及TMAD参数差异均无统计学意义(P均>0.05);恢复期A亚组基底段LS和心尖四腔观二尖瓣环平均位移率(AP4 Midpt%)较B亚组降低(P均<0.05)。结论超声心动图aCMQ技术可早期评估KD患儿左心室收缩功能;冠状动脉扩张影响KD患儿恢复期左心室功能。Objective To explore the value of echocardiographic automatic cardiac motion quantification(aCMQ)for evaluating left ventricular(LV)systolic function in children with Kawasaki disease(KD).Methods Totally 53 children with KD(KD group)who underwent routine intravenous immunoglobulin(IVIG)after admission were enrolled,including 22 with coronary artery ectasia(subgroup A)and 31 without coronary artery ectasia(subgroup B).Fifty-eight healthy children were used as the controls(control group).Echocardiography was performed for KD children within 12 h before treatment(acute phase),1 week after treatment(subacute phase)and 6-10 weeks after treatment(recovery phase),respectively.Conventional parameters of the left ventricle were measured using M-mode echocardiography,and the apical two-chamber,three-chamber and four-chamber 2D dynamic images of the left ventricle were obtained.The QLab 13.0 software was used for offline aCMQ analysis to obtain parameters related to left ventricular local longitudinal strain(LS),global longitudinal strain(GLS)and tracking of mitral annular displacement(TMAD)related parameters.Results There was no significant difference of the left ventricular ejection fraction(LVEF),left ventricular fraction shortening(LVFS),interventricular septum thickness at end-diastole(IVSD),left ventricular end-diastolic dimension(LVEDD)nor left ventricular end-systolic dimension(LVESD)between acute KD children and controls(all P>0.05).In children with acute and subacute KD,LS of basal segment,LS of middle segment,LS of apical segment,apical two chamber view LS(LS_(AP2)),apical three chamber view LS(LS_(AP3))and apical four chamber view LS(LS_(AP4))were all lower than those in controls,while LS of basal segment and LS_(AP4) in recovery phase of KD were lower than that in controls(all P<0.05).In children with subacute and recovery phase KD,LS of basal segment,LS of middle segment,LS of apical segment,LS_(AP2),LS_(AP3),LS_(AP4) and GLS of KD group were all higher than those in acute stage KD(all P<0.05),and LS of middle

关 键 词：黏膜皮肤淋巴结综合征 心室功能 左 超声心动描记术 自动心肌运动定量 

分 类 号：R543[医药卫生—心血管疾病] R540.4[医药卫生—内科学]