进行性假肥大性肌营养不良患儿左心房心肌应变与左心室功能的相关性  

Correlations between left atrial myocardial strain and left ventricular function in children with Duchenne muscular dystrophy

作　　者：冯洋 谌嘉琪 樊利 夏嘉敏 尹春梅 杨春江[1] FENG Yang;SHEN Jiaqi;FAN Li;XIA Jiamin;YIN Chunmei;YANG Chunjiang(Department of Ultrasound,Children's Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院超声科、国家儿童健康与疾病临床医学研究中心、儿童发育疾病研究教育部重点实验室、儿童神经发育与认知障碍重庆市重点实验室,重庆400014

出　　处：《中国医学影像技术》2025年第3期414-418,共5页Chinese Journal of Medical Imaging Technology

基　　金：重庆市科卫联合医学科研项目(2023MSXM097);重庆市技术创新与应用发展川渝科技创新合作计划(CSTB2024TIAD-CYKJCXX0030)。

摘　　要：目的观察进行性假肥大性肌营养不良(DMD)患儿左心房心肌应变与左心室功能的相关性。方法前瞻性纳入51例DMD患儿(DMD组)及42名健康儿童(对照组),比较2组常规超声及三维斑点追踪超声心动图(3D-STE)参数,分析左心房应变参数与左心室功能参数的相关性。结果DMD组二尖瓣环侧壁运动速度(e')、左心室射血分数(LVEF)、左心房射血分数(LAEF)、左心房室耦联指数(LACI)、左心室整体纵向应变(LVGLS)、左心房储备期应变(LASr)及左心房管道期应变(LAScd)均低于,而舒张早期二尖瓣峰值流速与e'比值(E/e')、左心房僵硬指数(LASI)及左心房充盈指数(LAFI)均高于对照组(P均<0.05)。DMD组LAEF、LASr及LAScd均与LVGLS呈中度正相关(r=0.409、0.437、0.440,P均<0.05),LAFI及LASI均与LVGLS呈弱负相关(r=-0.207、-0.223,P均<0.05);LASr与e'呈中度正相关(r=0.419,P<0.05)。结论DMD患儿左心房心肌应变与左心室收缩及舒张功能存在相关性。Objective To observe the correlations between left atrial myocardial strain and left ventricular function in children with Duchenne muscular dystrophy(DMD).Methods Fifty-one DMD children(DMD group)and 42 healthy one(control group)were prospectively enrolled.The parameters of routine ultrasound and three-dimensional speckle-tracking echocardiography(3D-STE)were compared between groups,and the correlations between left atrial strain parameters and left ventricular function parameters were analyzed.Results The mitral annular lateral wall velocity(e'),left ventricular ejection fraction(LVEF),left atrial ejection fraction(LAEF),left atrioventricular coupling index(LACI),left ventricular global longitudinal strain(LVGLS),left atrial strain during reservoir phase(LASr)and left atrial strain during conduit phase(LAScd)were all lower,while mitral early diastolic peak flow velocity/e'(E/e'),left atrial stiffness index(LASI)and left atrial filling index(LAFI)were higher in DMD group than those in control group(all P<0.05).In DMD group,LAEF,LASr and LAScd were moderately positively correlated with LVGLS(r=0.409,0.437,0.440,all P<0.05),LAFI and LASI were weakly negatively correlated with LVGLS(r=-0.207,-0.223,both P<0.05),while LASr was moderately positively correlated with e'(r=0.419,P<0.05).Conclusion The left atrial myocardial strain was correlated with left ventricular systolic and diastolic function in DMD children.

关 键 词：肌营养不良 杜氏 心室功能 左 心房功能 左 超声心动描记术 前瞻性研究 

分 类 号：R746.2[医药卫生—神经病学与精神病学] R540.45[医药卫生—临床医学]