实时三维超声心动图检测帕金森病患者心肌质量变化的临床价值  

Clinical value of real-time three-dimensional echocardiography in detecting myocardial mass changes in patients with Parkinson’s disease

作　　者：王晓瑛 陈静 杨新新 WANG Xiaoying;CHEN Jing;YANG Xinxin(Department of Ultrasound,the Affiliated Hospital of Xuzhou Medical University,Jiangsu 221006,China)

机构地区：[1]徐州医科大学附属医院心脏彩超室,江苏省徐州市221006 [2]徐州医科大学附属医院神经内科,江苏省徐州市221006

出　　处：《临床超声医学杂志》2022年第10期727-731,共5页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金项目(81671269);江苏省青年医学重点人才基金项目(QNRC2016789)。

摘　　要：目的应用实时三维超声心动图(RT-3DE)测量帕金森病患者左室心肌质量指数(LVMI),探讨帕金森病对心脏功能的影响。方法选取我院经临床确诊的帕金森病患者75例,根据Hoehn-Yahr分级标准分为早期组(1~2级)36例和中晚期组(3~5级)39例,收集并比较两组患者的临床资料,包括年龄、性别、病程、血压、美多芭等效剂量、帕金森病评价量表评分(UPDRS评分)。另选年龄、性别相匹配的健康成人75例为健康对照组。应用RT-3DE测量各组LVMI、左室收缩功能参数,包括左室舒张末容积指数(LVEDVI)、左室每搏指数(LVSVI)及左室射血分数(LVEF)等,比较各组RT-3DE参数的差异。分析LVMI与各临床资料的相关性。结果早期组与中晚期组美多芭等效剂量、病程、心率、收缩压、舒张压、UPDRS评分比较,差异均有统计学意义(均P<0.05)。中晚期组LVMI、LVSVI、LVEF均低于早期组、健康对照组,差异均有统计学意义(均P<0.05),其余参数两两比较差异均无统计学意义。相关性分析显示,LVMI与UPDRS评分、病程、美多芭等效剂量均呈负相关(r=-0.512、-0.438、-0.621,P=0.024、0.004、0.019),与年龄、性别、心率、收缩压、舒张压均无相关性。结论应用RT-3DE检测中晚期帕金森病患者LVMI变化,有助于评估帕金森病对心脏功能的影响程度。Objective To measure the left ventricular myocardial mass index(LVMI)in patients with Parkinson’s disease(PD)by real-time three-dimensional echocardiography(RT-3DE),and to investigate the effect to Parkinson’s disease on cardiac function.Methods Seventy-five patients with Parkinson’s disease in our hospital were selected and divided into early stage group(grade 1~2,n=36)and middle and late stage group(grade 3~5,n=39)according to Hoehn-Yahr staging criteria.The clinical data of the two groups were collected and compared,including age,gender,course of disease,blood pressure,Madopar equivalent dose,Parkinson’s disease rating scale(UPDRS)score.75 healthy adults with matched age and gender were selected as the healthy control group.LVMI and left ventricular systolic function indexes including left ventricular end-diastolic volume index(LVEDVI),left ventricular stroke volume index(LVSVI)and left ventricular ejection fraction(LVEF)were obtained by RT-3DE.The differences of RT-3DE parameters in each group were compared,and the correlation between LVMI and clinical data was analyzed.Results There were significant differences in the Madopar equivalent dose,course of disease,heart rate,systolic blood pressure,diastolic blood pressure,and UPDRS score between the early group and the middle and late group(all P<0.05).LVMI,LVSVI and LVEF in the middle and late stage group were lower than those in the early stage group and the healthy control group,and the differences were statistically significant(all P<0.05),and there were no significant differences in the other pairwise comparisons.Correlation analysis showed that LVMI was negatively correlated with UPDRS score,course of disease and Madopar equivalent dose(r=-0.512,-0.438,-0.621,P=0.024,0.004,0.019),but was no correlated with age,gender,heart rate,systolic and diastolic blood pressure.Conclusion Detecting the changes of LVMI in patients with middle and late Parkinson’s disease by RT-3DE is helpful to evaluate the impact of Parkinson’s disease on cardiac function.

关 键 词：超声心动描记术 三维 实时 帕金森病 左室心肌质量指数 心室功能 左 

分 类 号：R540.45[医药卫生—心血管疾病] R746.9[医药卫生—内科学]