二维斑点追踪技术及实时三维超声心动图评价系统性硬化症患者左室亚临床心肌受累  

Evaluation of left ventricular subclinical myocardial involvement in systemic sclerosis patients by two-dimensional speckle tracking imaging and real-time three-dimensional echocardiography

作　　者：许惠宁 郭泰 芦芳[3] XU Huining;GUO Tai;LU Fang(College of Medical Imaging,Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学医学影像学院,太原市030001 [2]山西白求恩医院骨科 [3]山西医科大学第二医院超声科

出　　处：《临床超声医学杂志》2024年第11期951-956,共6页Journal of Clinical Ultrasound in Medicine

摘　　要：目的 应用二维斑点追踪技术(2D-STI)及实时三维超声心动图(RT-3DE)评价系统性硬化症(SSc)患者左室亚临床心肌受累。方法 选取我院无明显结构性心脏病及肺动脉高压的SSc患者33例(病例组)及同期健康志愿者33例(对照组),应用2D-STI获取左室整体纵向峰值应变(GLPS)、18节段纵向峰值应变(LPS)、整体圆周峰值应变(GCPS)及左室基底段、中间段、心尖段圆周峰值应变(CPS-B、CPS-M、CPS-A),RT-3DE获取左室舒张末期容积(3DLVEDV)、左室收缩末期容积(3D-LVESV)、左室射血分数(3D-LVEF)、左室16节段达最小收缩容积时间的标准差(Tmsv-16-SD)、左室16节段达最小收缩容积时间的最大时间差(Tmsv-16-Dif)、经R-R间期校正后的左室16节段达最小收缩容积时间的标准差占心动周期的百分比(Tmsv-16-SD%)及经R-R间期校正后的左室16节段达最小收缩容积时间的最大时间差占心动周期的百分比(Tmsv-16-Dif%),比较两组上述各参数的差异。结果 2D-STI检查结果显示,病例组GLPS及前壁、前间隔、后间隔、下壁、下侧壁、前侧壁基底段、中间段LPS,以及前壁、前间隔、前侧壁心尖段LPS均低于对照组,差异均有统计学意义(均P<0.05);两组GCPS、CPS-B、CPS-M、CPS-A,以及后间隔、下壁、下侧壁心尖段LPS比较差异均无统计学意义。RT-3DE检查结果显示,病例组3D-LVEDV、3D-LVEF均低于对照组,Tmsv-16-SD、Tmsv-16-Dif、Tmsv-16-SD%和Tmsv-16-Dif%均高于对照组,差异均有统计学意义(均P<0.05)。结论 2D-STI及RT-3DE有助于早期发现SSc患者左室亚临床心肌受累情况,为临床诊治及疗效评估提供参考。Objective To evaluate the left ventricular subclinical myocardial involvement in systemic sclerosis(SSc)patients by two-dimensional speckle tracking imaging(2D-STI)and real-time three-dimensional echocardiography(RT-3DE).Methods Thirty-three SSc patients without obvious structural heart disease or pulmonary hypertension(case group)and 33 healthy volunteers(control group)in our hospital were selected.The left ventricular global longitudinal peak strain(GLPS),18-segment longitudinal peak strain(LPS),global circumferential peak strain(GCPS),and left ventricular basal,middle,apical circumferential peak strain(CPS-B,CPS-M,CPS-A)were obtained by 2D-STI.The left ventricular end-diastolic volume(3D-LVEDV),left ventricular end-systolic volume(3D-LVESV),left ventricular ejection fraction(3D-LVEF),standard deviation of time to minimum systolic volume in 16 segments of left ventricle(Tmsv-16-SD),maximum time difference of time to minimum systolic volume in 16 segments of left ventricle(Tmsv-16-Dif),percentage of standard deviation of time to minimum systolic volume in 16 segments of left ventricle corrected by R-R interval in cardiac cycle(Tmsv-16-SD%)and percentage of maximum time difference of time to minimum systolic volume in 16 segments of left ventricle corrected by R-R interval in cardiac cycle(Tmsv-16-Dif%)were obtained by RT-3DE.The differences of the above parameters between the two groups were compared.Results 2D-STI results showed that GLPS and LPS in the basal and mid segments of the anterior wall,anterior septum,anterior lateral wall in the case group were lower than those in the control group,with statistically significant differences(all P<0.05).There were no significant differences in GCPS,CPS-B,CPS-M,CPS-A and LPS in the apical posterior septum,inferior wall,inferior lateral wall between the two groups.RT-3DE results showed that 3D-LVEDV and 3D-LVEF in the case group were lower than those in the control group,and Tmsv-16-SD,Tmsv-16-Dif,Tmsv-16-SD%,Tmsv-16-Dif%were higher than those in the control group,with

关 键 词：超声心动描记术 三维 实时 斑点追踪技术 系统性硬化症 心室 左 

分 类 号：R540.45[医药卫生—心血管疾病]