多模态超声心动图联合应变及三尖瓣环位移参数对肺炎支原体肺炎儿童右心室功能的临床诊断价值  

Clinical diagnostic value of multimodal echocardiography combined with strain and tricuspid annulus displacement parameters for right ventricular function in children with mycoplasma pneumonia

作　　者：王子玥 栗河舟[1] 吴娟[1] 王新霞[1] 张君玲[1] 杨坡[1] 齐芳芳 刘芝姣 WANG Ziyue;LI Hezhou;WU Juan;WANG Xinxia;ZHANG Junling;YANG Po;QI Fangfang;LIU Zhijiao(Department of Ultrasound,The Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院超声医学科,河南郑州450052

出　　处：《分子影像学杂志》2025年第2期211-217,共7页Journal of Molecular Imaging

基　　金：河南省医学教育研究联合共建项目(Wjlx2020091)。

摘　　要：目的探讨多模态超声心动图评估肺炎支原体肺炎(MPP)儿童右心室功能的应用价值。方法选取2024年1~3月在郑州大学第三附属医院就诊的MPP急性期儿童45例(MPP组)和同期健康儿童50例(对照组),运用二维斑点追踪(STI)技术测定右心室应变参数及三尖瓣环位移(TAD)参数,并应用传统二维超声心动图,频谱多普勒、组织多普勒成像(TDI)等不同超声评估方法进行右心室功能检查。对比两组儿童右心室径线(RVT、RVL)、三尖瓣频谱多普勒参数(TVE、TVA、TVE/A)、肺动脉瓣频谱多普勒参数(PVAT、PV)、三尖瓣环组织多普勒参数(s、e、a、IVCT、ET、IVRT、TDI-Tei指数)、右心室纵向应变参数(RV4CSL、RVFWSL)与TAD参数(T1、T2、Tm%、Tm)。运用Pearson相关性分析法分析MPP组患儿应变参数和TAD参数与心肌酶谱结果的相关性。结果与正常组相比,MPP组TVE和TVA增快、ET缩短、TDI-Tei指数增大(P<0.05),但TVE/A、三尖瓣环e/a与正常组相比差异无统计学意义(P>0.05);右心室纵向应变参数(RV4CSL、RVFWSL)及TAD参数(T1、T2、Tm%、Tm)均较对照组降低(P<0.05);MPP组应变和TAD参数与心肌酶谱结果呈负相关,其中Tm%与LDH,RV4CSL与LDH,Tm%与CK-MB,Tm%与CK,RV4CSL与CK-MB的相关性均较好(r=-0.706、-0.658、-0.664、-0.654、-0.636,P<0.05)。结论MPP患儿右心室整体功能减低,主要为收缩功能受损,舒张功能无影响;STI技术测定右心室应变参数及TAD参数有助于早期发现并量化评价MPP的右心室心肌收缩功能障碍;MPP患儿心肌酶谱水平越高,右心室应变参数及TAD参数越低,其右心室亚临床心肌受损程度越严重。Objective To explore the value of multimodal echocardiographic assessment of right ventricular function in children with Mycoplasma pneumoniae pneumonia(MPP).Methods Forty-five children in the acute phase of MPP(MPP group)and fifty healthy children in the same period(control group)who attended the Third Affiliated Hospital of Zhengzhou University from January to March 2024 were selected.Two-dimensional speckle tracking(STI)technique was used to ascertain right ventricular strain parameters and TAD parameters,and different ultrasound assessment methods such as conventional 2D echocardiography,spectral Doppler,and tissue Doppler imaging(TDI)were applied for right ventricular function examination.Compare the differences in the right ventricular diameter parameters(RVT,RVL),tricuspid valve spectral Doppler parameters(TVE,TVA,TVE/A),pulmonary valve spectral Doppler parameters(PVAT,PV),tricuspid annular tissue Doppler parameters(s,e,a,IVCT,ET,IVRT,TDI-Tei index),right ventricular longitudinal strain parameters(RV4CSL,RVFWSL)with TAD parameters(T1,T2,Tm%,Tm)between two groups of children.Correlation of strain parameters and TAD parameters with myocardiac enzyme spectrum results in the MPP group using Pearson's correlation analysis,respectively.Results TVE and TVA increased,ET shortened,and TDI-Tei index increased in the MPP group compared with the control group(P<0.05).However,there were no significant differences in TVE/A and tricuspid annulus e/a compared with the control group(P>0.05);The right ventricular longitudinal strain parameters(RV4CSL,RVFWSL)and TAD parameters(T1,T2,Tm%,Tm)were reduced compared with the control group(P<0.05);The strain and TAD parameters in the MPP group were negatively correlated with myocardiac enzyme spectrum results,with better correlations between Tm%and LDH,RV4CSL and LDH,Tm%and CK-MB,Tm%and CK,RV4CSL and CK-MB(r=-0.706,-0.658,-0.664,-0.654,-0.636,P<0.05).Conclusion In children with MPP,the overall function of the right ventricle was impaired,with impaired systolic function and no effe

关 键 词：肺炎支原体肺炎 右心室功能 二维斑点追踪技术 组织多普勒成像 心肌应变 三尖瓣环位移 

分 类 号：R540.45[医药卫生—心血管疾病] R725.6[医药卫生—内科学]