左心室压力-应变环评价缺铁性贫血患者左室收缩功能的研究  

Evaluation of left ventricular systolic function in patients with iron deficiency anemia by left ventricular pressure-strain loop

作　　者：景萌 崔秀秀 侯烜宁 宋庆飞 王小艳[1] JING Meng;CUI Xiu-xiu;HOU Xuan-ning;SONG Qing-fei;WANG Xiao-yan(Department of Ultrasound,Heping Hospital Affiliated to Changzhi Medical College,Changzhi Shanxi 046000,China)

机构地区：[1]长治医学院附属和平医院超声医学科,山西长治046000

出　　处：《中国临床医学影像杂志》2024年第5期333-337,共5页Journal of China Clinic Medical Imaging

基　　金：“四个一批”科技兴医创新计划项目(2022XM19)。

摘　　要：目的:应用无创性左室压力应变环技术(LV-PSL)定量评估缺铁性贫血(IDA)患者左室收缩功能的早期改变。方法:选取2022年3月—2023年2月我医院确诊的IDA患者62例作为病例组,按照血红蛋白(Hb)浓度的高低分为两组:B组Hb>9 g/dL,C组Hb>6~9 g/dL。同期33例健康人作为对照A组。收集相关临床资料数据,对三组均进行超声心动图检查并采集常规超声参数,利用二维斑点追踪技术和LV-PSL分析得出左室整体纵向应变(GLS)、整体做功指数(GWI)、整体有用功(GCW)、整体无用功(GWW)、整体做功效率(GWE)。比较三组间GLS及心肌做功参数的变化,分析心肌做功参数与GLS的相关性。结果:与A组比较,B组GWI、GCW均减低(均P<0.01)。与A组、B组比较,C组GLS、GWI、GCW和GWE、E/A均减低,GWW、LVEDV、LVESV、meanE/e’均增加(均P<0.01)。相关性分析结果显示,GLS与GWI、GCW、GWE呈正相关关系(r=0.697、0.681、0.447,均P<0.01),与GWW呈负相关关系(r=-0.411,均P<0.01)。结论:LV-PSL可无创定量评估长期不同程度IDA患者早期左室收缩功能受损情况,且左室收缩功能随着贫血程度的加重逐步降低。Objective:To apply non-invasive left ventricular pressure-strain loop(LV-PSL)to quantitatively assess early changes in left ventricular systolic function in patients with iron deficiency anemia(IDA).Methods:Sixty-two patients with IDA diagnosed at the Heping Hospital Affiliated to Changzhi Medical College from March 2022 to February 2023 were selected as the case group and divided into two groups according to the concentration of hemoglobin(Hb):group B with Hb>9 g/dL and group C with Hb>6~9 g/dL.In addition,33 healthy individuals were used as control group A during the same period.Relevant clinical data were collected,echocardiography was performed and conventional ultrasound parameters were collected in all three groups,while global longitudinal strain(GLS),global work index(GWI),global constructive work(GCW),global waste work(GWW),global work efficiency(GWE)were obtained using 2D speckle tracking technique and LV-PSL analysis.The changes in GLS and myocardial work parameters were compared among the three groups,and the correlation between myocardial work parameters and GLS was analyzed.Results:Compared with group A,GWI and GCW were reduced in group B(both P<0.01).Compared with groups B and A,GLS,GWI,GCW and GWE,and E/A were all decreased,and GWW,LVEDV,LVESV,and meanE/e’were all increased in group C(all P<0.01).Correlation analysis showed that GLS was positively correlated with GWI,GCW and GWE(r=0.697,0.681,and 0.447,all P<0.01),and negatively correlated with GWW(r=-0.411,all P<0.01).Conclusion:LV-PSL can provide noninvasive quantitative assessment of early impaired left ventricular systolic function in patients with varying degrees of long-term IDA,and left ventricular systolic function progressively decreases with increasing degrees of anemia.

关 键 词：心室功能 左 贫血 超声心动描记术 

分 类 号：R556[医药卫生—血液循环系统疾病] R331.31[医药卫生—内科学] R540.45[医药卫生—临床医学]