斑点追踪成像评价肝硬化患者肝移植前后右心功能变化的研究  

Evaluation of Right Heart Function Changes After Liver Transplantation in Cirrhotic Patients by Speckle Tracking Imaging

作　　者：江佳楠 李勇[1] 孟媛媛[1] 刘冉冉[1] 付秀秀[1] 孙品[1] 王志斌[1] Jiang Jianan;Li Yong;Meng Yuanyuan;Liu Ranran;Fu Xiuxiu;Sun Pin;Wang Zhibin(Department of Cardiac Ultrasound,Affiliated Hospital of Qingdao University,Qingdao,Shandong 266000,China)

机构地区：[1]青岛大学附属医院心脏超声科,山东省青岛市266000

出　　处：《中国超声医学杂志》2024年第7期767-770,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 应用右心室三维超声心动图(3DE)及斑点追踪成像(STI)评价肝硬化患者右心室功能及其肝移植前后的改变。方法 将75例肝硬化患者按照蔡尔德-皮尤(Child-Pugh)分级标准分为A级组27例、B级组22例和C级组26例,18例患者行肝移植手术。对照组为25例健康志愿者。应用3DE及STI获得右心室三维参数:右心室舒张末期容积(RVEDV)、右心室收缩末期容积(RVESV)、右心室射血分数(RVEF)及右心室游离壁纵向应变(RVFWLS)、右心室整体纵向应变(RVGLS),分析上述参数与肝功能分级的相关性及其肝移植前后的变化。结果 RVEDV、RVESV、RVEDVi、RVESVi与肝功能分级均呈正相关。肝移植术后RVGLS、RVFWLS的绝对值较术前增大,RVEDV、RVESV、RVEDVi、RVESVi较术前减小(P<0.05)。结论 3DE及STI能反映肝硬化患者右心室功能的早期改变,并对肝移植术后患者右心室功能进行定量评估,协助临床改善患者远期预后。Objective To evaluate the right ventricular function in patients with cirrhosis and its changes after liver transplantation by three-dimensional echocardiography(3DE) and speckle tracking imaging(STI).Methods A total of 75 cirrhotic patients were divided into Child-Pugh A group(n=27),Child-Pugh B group(n=22),and Child-Pugh C group(n=26) according to the Child-Pugh classification criteria,18 patients underwent liver transplantation.25 healthy volunteers were enrolled as control group.3DE was applied to obtain three-dimensional parameters of the right ventricle:right ventricular end-diastolic volume(RVEDV),right ventricular end-systolic volume(RVESV),right ventricular ejection fraction(RVEF),and right ventricular free-wall longitudinal strain(RVFWLS),right ventricular global longitudinal strain(RVGLS).The correlation between right ventricular function and classification of liver function were analyzed,and the right ventricular function changes after operation were compared.Results There has a positive correlation among RVEDV,RVESV,RVEDVi and RVESVi and liver function grade.Compared with the parameters before liver transplantation,the absolute value of RVGLS and RVFWLS were increased,and RVEDV,RVESV,RVEDVi,RVESVi were decreased after liver transplantation(P<0.05).Conclusions 3DE and STI can reflect the early changes of right ventricular function in patients with liver cirrhosis,and can quantitatively evaluate the right ventricular function in patients after liver transplantation,which may improve the long-term prognosis of patients in clinical.

关 键 词：斑点追踪成像 三维超声心动图 肝移植 右心室功能 

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]