三维超声心动图评估中度肥厚型心肌病患儿乳头肌、二尖瓣结构和功能的应用价值  

The application value of three-dimensional echocardiographic assessment of papillary muscles and mitral valve structure and function in children with moderate hypertrophic cardiomyopathy

作　　者：汪小开 金丽仙[1] 应夏青 WANG Xiaokai;JIN Lixian;YING Xiaqing(Department of Ultrasound,Lishui People's Hospital,Lishui 323000,China;不详)

机构地区：[1]丽水市人民医院超声科,323000 [2]丽水市人民医院妇产科,323000

出　　处：《心电与循环》2023年第5期444-448,共5页Journal of Electrocardiology and Circulation

摘　　要：目的探讨三维超声心动图评估中度肥厚型心肌病(HCM)患儿乳头肌、二尖瓣结构和功能的应用价值。方法选取2018年1月至2021年12月丽水市人民医院收治的30例中度HCM患儿为观察组,同期本院体检的30名健康儿童为对照组;均予三维超声心动图检查,记录并比较两组对象乳头肌和左心室相关参数[前乳头肌质量指数、乳头肌总质量指数、左心室质量指数、前乳头肌长度、乳头肌顶部移位指数(APL)等]以及二尖瓣相关参数(球度指数、后叶面积、后叶长、后叶角等)。采用ROC曲线分析各项参数对中度HCM的预测效能。结果观察组患儿前乳头肌质量指数、乳头肌总质量指数、左心室质量指数以及球度指数、后叶面积、后叶长均明显大于对照组,前乳头肌长度、APL以及后叶角均明显小于对照组,差异均有统计学意义(均P<0.05)。左心室质量指数、左心室侧壁长度、后叶面积对中度HCM均有一定的预测价值,其AUC、截断值、灵敏度、特异度分别为0.826、76.83 g/m^(2)、0.793、0.809,0.874、105.32 cm、0.825、0.782以及0.755、6.28 cm^(2)、0.857、0.872,差异均有统计学意义(均P<0.05)。结论三维超声心动图评估中度HCM患儿乳头肌、二尖瓣结构和功能具有一定的应用价值,有助于疾病早期诊断。Objective To explore the application value of three-dimensional echocardiography in assessing papillary muscle and mitral valve structure and function in children with moderate hypertrophic cardiomyopathy(HCM).Methods Thirty children with moderate HCM admitted to Lishui People's Hospital from January 2018 to December 2021 were selected as the observation group,and 30 healthy children undergoing physical examinations at the same hospital during the same period were selected as the control group.All subjects underwent three-dimensional echocardiography,and the relevant parameters of papillary muscles and left ventricular,including anterior papillary muscle mass index,total papillary muscle mass index,left ventricular mass index,anterior papillary muscle length,and papillary muscle apical displacement index(APL),etc.,as well as mitral valve related parameters including sphericity index,posterior leaflet area,posterior leaflet length,and posterior leaflet angle.ROC curve analysis was used to evaluate the predictive efficacy of various parameters for moderate HCM.Results The anterior papillary muscle mass index,total papillary muscle mass index,left ventricular mass index,sphericity index,posterior leaflet area,and posterior leaflet length of the observation group were significantly higher than those of the control group.Additionally,the anterior papillary muscle length,APL index and posterior leaflet angle were significantly smaller than the control group.All differences were statistically significant(all P<0.05).The left ventricular mass index,left ventricular lateral wall length,and posterior leaflet area had certain predictive value for moderate HCM,with AUC,cut-off values,sensitivity,and specificity of 0.826,76.83 g/m2,0.793,0.809;0.874,105.32 cm,0.825,0.782;and 0.755,6.28 cm2,0.857,0.872,respectively,all differences were statistically significant(all P<0.05).Conclusion Three-dimensional echocardiographic assessment of papillary muscle and mitral valve structure and function in children with moderate HCM has cert

关 键 词：三维超声心动图 肥厚型心肌病 二尖瓣 乳头肌 儿童 

分 类 号：R725.4[医药卫生—儿科] R540.45[医药卫生—临床医学]