自动心肌功能成像评价肝硬化心肌病患者左心室心肌做功的研究  

Evaluation of Left Ventricular Myocardial Work in Patients with Cirrhotic Cardiomyopathy by Automated Myocardial Function Imaging

作　　者：张雪[1] 闫国珍[2] 王晶[3] 李刚[1] 张小青 李煦灵 Zhang Xue;Yan Guozhen;Wang Jing;Li Gang;Zhang Xiaoqing;Li Xuling(Department of Ultrasound,The Second Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou,Inner Mongolia 014031,China;Department of Ultrasound,The First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou,Inner Mongolia 014017,China;Department of Gastroenterology,The Second Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou,Inner Mongolia 014031,China)

机构地区：[1]内蒙古科技大学包头医学院第二附属医院超声科,内蒙古包头市014031 [2]内蒙古科技大学包头医学院第一附属医院超声科,内蒙古包头市014017 [3]内蒙古科技大学包头医学院第二附属医院消化内科,内蒙古包头市014031

出　　处：《中国超声医学杂志》2024年第7期757-761,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 应用自动心肌功能成像(AFI)评估肝硬化心肌病(CCM)患者左心室心肌做功情况。方法 收集肝硬化患者137例,根据2020年CCM指南诊断标准分为CCM组(53例)和非CCM组(84例),正常对照组(50例)根据性别及年龄匹配。收集一般临床资料、常规超声指标、心肌应变及左心室心肌做功参数,比较组间差异。结果 CCM组和非CCM组比较,CCM组左心室射血分数(LVEF)、整体纵向应变(GLS)绝对值、整体做功指数(GWI)、整体做功效率(GWE)、整体有用功(GCW)均低于非CCM组,整体无用功(GWW)、峰值应变离散度(PSD)均高于非CCM组(P<0.05)。非CCM组和正常对照组比较,非CCM组GWW、PSD高于正常对照组,GWE低于正常对照组(P<0.05),LVEF、GLS、GWI和GCW在两组间无明显差异。GWI和GCW可作为判断CCM患者左心室收缩功能障碍的指标,PSD、GWW和GWE可早于LVEF和GLS发现肝硬化患者左心室收缩功能异常。结论 AFI可敏感地发现肝硬化患者亚临床收缩功能障碍,在诊断CCM方面有较大的应用价值,能为临床诊疗提供有力依据。Objective To evaluate left ventricular myocardial work in patients with cirrhotic cardiomyopathy(CCM) by automated myocardial functional imaging(AFI).Methods A total of 137 patients with cirrhosis were collected and divided into CCM group(53 cases) and non-CCM group(84 cases) according to the 2020 CCM guidelines,and normal control group(50 cases) according to gender and age matching.General clinical data,routine ultrasound indicators,myocardial strain and left ventricular myocardial work parameters were collected to compare the differences between groups.Results Compared with the non-CCM group,the left ventricular ejection fraction(LVEF),the absolute value of left ventricular global longitudinal strain(GLS),the global work index(GWI),the global work efficiency(GWE) and the global constructive work(GCW) in the CCM group were all lower than those in the non-CCM group.Global wasted work(GWW) and peak strain dispersion(PSD) were higher than those in non-CCM group(P<0.05).Compared with the normal control group,GWW and PSD in the non-CCM group were higher than those in the normal control group,GWE were lower than those in the normal control group(P<0.05),and LVEF,GLS,GWI and GCW were not significantly different between the two groups.GWI and GCW can be used as indicators to determine left ventricular systolic dysfunction in patients with CCM.PSD,GWW and GWE can detect left ventricular systolic dysfunction in patients with cirrhosis earlier than LVEF and GLS.Conclusions AFI can sensitively detect subclinical systolic dysfunction in patients with cirrhosis,and has great application value in the diagnosis of CCM,which can provide a strong basis for clinical diagnosis and treatment.

关 键 词：自动心肌功能成像 肝硬化心肌病 心肌做功 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.2[医药卫生—诊断学] R542.2[医药卫生—临床医学]