实时三维超声心动图评价儿童川崎病左心室收缩不同步性的应用研究

Assessment of left ventricular dyssynchrony in children with Kawasaki disease by real-time three-dimensional echocardiography

目的探讨实时三维超声心动图对儿童川崎病左心室不同步性的应用价值研究。方法收集了新华医院川崎病患者38例,健康志愿者18例。(1)分析所有患者的二维经胸超声心动图Simpson法所测射血分数(EF)值。(2)经Q-lab软件分析所有患者的实时三维超声心动图并计算16节段和12节段的标准差及最大时间差的绝对值及占平均心动周期的百分比,并与正常组对比。结果 (1)川崎病患者Simpson法所测EF值与正常组相比明显降低,左心室整体收缩功能受损。(2)川崎病组16节段的标准差及最大时间差的绝对值及占平均心动周期的百分比与正常对照组相比升高,但组间差异无统计学意义(P>0.05);12节段组的标准差及最大时间差的绝对值及占平均心动周期的百分比与正常对照组相比,组间差异有统计学意义(P<0.05)。二维Simpson法所测左心室EF与三维测量值呈中等程度相关。结论实时三维超声心动图测定的16和12节段的标准差及最大时间差的绝对值可作为评价左心室心肌收缩不同步性的有效指标。二维超声心动图和实时三维超声心动图两种方法所测EF值一致性较好。

Objective To assess the left ventricular dyssynchrony by real-time three-dimensional echocardiography in children with Kawasaki disease.Methods A total of 38 cases of Kawasaki disease hospitalized were analyzed retrospectively,18 normal controls were enrolled.Ejection fraction measured by Simpson＇s method and real time three dimensional echocardiography was analyzed and compared between the two groups.The time to the point of minimal systolic volume and its standard deviation and maximal difference were analyzed by real-time three-dimensional echocardiography.Results Compared with normal group,ejection fraction measured by Simpson＇s method was decreased,the global systolic function was impaired.Compared with normal group,the time to the point of minimal systolic volume of left ventricular in 16 segments and their standard deviation and maximal difference were slightly higher（P0.05）.The time to the point of minimal systolic volume of left ventricular in 12 segments and its standard deviation and maximal difference were significantly higher（P0.05）.Ejection fraction measured by Simpson＇s method was medium degree related to ejection fraction measured by real-time three-dimensional echocardiography.Conclusions New echocardiographic techniques can assess left ventricular dyssynchrony in children with Kawasaki disease.The time to the point of minimal systolic volume and its standard deviation and maximal difference are important in evaluating the left ventricular systolic dyssynchrony.The data of EF measured by two-dimensional and three-dimensional echocardiography have good consistency.