超声造影评估心尖肥厚型心肌病的价值分析  

Value of contrast-enhanced ultrasound in evaluation of apical hypertrophic cardiomyopathy

作　　者：刘莹 王海燕 杜莉娟 肖海萍[2] Liu Ying;Wang Haiyan;Du Lijuan;Xiao Haiping(Department of Ultrasound,the Third People’s Hospital of Henan Province,Zhengzhou 450006,China;Department of Ultrasound,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]河南省直第三人民医院超声科,郑州450006 [2]郑州大学第二附属医院超声科,郑州450000

出　　处：《中国实用医刊》2022年第21期78-81,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨超声造影评估心尖肥厚型心肌病(AHCM)的价值。方法回顾性分析2019年6月至2022年1月河南省直第三人民医院收治的95例疑似AHCM患者的临床资料,所有疑似病例均接受超声心动图、超声造影检查。依据超声造影诊断结果为参考标准,将其中64例确诊为AHCM的患者纳入AHCM组,31例检查结果正常者纳入正常对照组。观察两组超声造影肥厚心肌节段的心肌灌注指标[造影剂平台峰值强度(A)、曲线上升斜率(β)、A×β];比较两组左心室收缩/舒张功能指标[左室射血分数(LVEF)、二尖瓣血流频谱E峰与A峰的比值(E/A)、左房整体峰值纵向应变(LAPGLS)、左房面积变化分数(FAC)];采用一般线性双变量Pearson直线相关检验分析AHCM患者A、β、A×β值与其左心室舒张功能的关系。结果AHCM组肥厚心肌节段A、β、A×β值均低于正常对照组,差异有统计学意义(P<0.05);AHCM组左心房舒张功能参数E/A、LAPGLS、FAC均低于正常对照组(P均<0.05);两组LVEF比较差异未见统计学意义(P>0.05)。经一般线性双变量Pearson直线相关性检验,结果显示,AHCM患者超声造影心肌灌注指标A、β、A×β值均与E/A、LAPGLS、FAC呈正相关(r均>0,P均<0.05)。结论超声造影可及时发现病变心肌灌注异常,定量评价AHCM患者心肌微循环灌注情况,且其心肌灌注指标A、β、A×β值可反映AHCM患者左心房舒张功能损伤程度。Objective To investigate the value of contrast-enhanced ultrasound in evaluation of apical hypertrophic cardiomyopathy(AHCM).Methods The clinical data of 95 suspected AHCM patients admitted to the Third People’s Hospital of Henan Province from June 2019 to January 2022 were retrospectively analyzed.All suspected cases underwent echocardiography and contrast-enhanced ultrasound.Taking the results of contrast-enhanced ultrasound diagnosis as the reference standard,64 patients with AHCM were included in the AHCM group,and 31 persons with normal examination results were included in the normal control group.Myocardial perfusion indexes including peak intensity(A)of contrast medium platform,slope of curve rise(β),A×β of hypertrophic myocardial segments of the two groups were observed;the indexes of left ventricular systolic/diastolic function including left ventricular ejection fraction(LVEF),ratio of E peak to A peak of mitral flow spectrum(E/A),left atrial peak global longitudinal strain(LAPGLS),and left fraction area change(FAC)were compared between the two groups.General linear bivariate Pearson linear correlation was used to test the relationship of A,β,A×β values with left ventricular diastolic function in patients with AHCM.Results The values of A,βand A×β of hypertrophic myocardium in the AHCM group were lower than those in the normal control group(P<0.05);the left atrial diastolic function parameters including E/A,LAPGLS and FAC in the AHCM group were lower than those in the normal control group(all P<0.05).There was no significant difference in LVEF between the two groups(P>0.05).The results of the general linear bivariate Pearson linear correlation test showed that the values of myocardial perfusion index A,β and A×β in AHCM patients were positively correlated with E/A,LAPGLS and FAC(all r>0,all P<0.05).Conclusions Contrast-enhanced ultrasound can detect abnormal myocardial perfusion in time and quantitatively evaluate myocardial microcirculation perfusion in patients with AHCM,and the values o

关 键 词：肥厚型心肌病 心尖肥厚 超声心动图 超声造影 诊断价值 

分 类 号：R445.1[医药卫生—影像医学与核医学] R542.2[医药卫生—诊断学]