应变率成像评价左室不同充盈模式患者左室心肌功能的临床研究

ASSESSMENT OF LEFT VENTRICLE FUNCTION IN PATIENTS WITH DIFFERENT FILLING PATTERNS OF LEFT VENTRICLE BY STRAIN RATE

目的:运用超声心动图应变率成像(SRI)技术评估左室不同充盈模式患者左室心肌功能,探讨其临床应用价值。方法:左室正常充盈组21例为正常对照,左室非正常充盈模式患者62例,患者根据舒张期左室不同充盈模式按舒张功能受损程度逐级分为松弛性下降组、假性充盈正常组和限制性充盈组,行二维超声心动图、三维超声心动图和SRI检查,记录左室各壁收缩期应变率峰值(Systolic strain rate,SSR),舒张早期应变率峰值(Early diastolic peak strain rate,ESR),舒张晚期应变率峰值(Late diastolic peak strain rate,ASR)。结果:松弛性下降组ESR小于正常充盈组(P<0.05)而大于假性充盈正常组和限制性充盈组(P<0.05);ASR在左室非正常充盈模式中,松弛性下降组和假性充盈正常组大于正常充盈组,在松弛性下降组与假性充盈正常组相比差异无统计学意义(P>0.05),在正常充盈组、松弛性下降组、限制性充盈组间相比差异有统计学意义(P<0.05);SSR在正常充盈组与松弛性下降组相比差异无统计学意义(P>0.05),正常充盈组、假性充盈正常组、限制性充盈组间相比差异有统计学意义(P<0.05),SSR在假性充盈正常组达最大值。结论:SRI能客观、定量评价左室不同充盈模式患者左室心肌功能的变化,为临床评价左室非正常充盈模式下左室心肌功能的损害程度提供定量指标。

Objective：The objective of this study was to evaluate left ventricular function in patients with left ventricular abnormal filling pattern by using strain rate imaging （SRI）, and to investigate the clinical value of the SRI in the evaluation of left ventricular function. Methods： Twenty-one persons with left normal fill- ing were recruited as normal group. Sixty-two patients with abnormal left ventricular diastolic function were divided into the relaxation drop, pseudonormal filling and restrictive filling groups according to differ- ent filling patterns of the left ventricle. Two-dimensional ultrasound echocardiography, three-dimensional ultrasound echocardiography and strain rate imaging technique were performed. The peak systolic strain rate （SSR）, early diastolic peak strain rate （ESR）, and late diastolic peak strain rate （ASR） of each wall of the left ventricule were recorded, then analyzed and compared among groups. Results： The ESR in relaxa tion drop group was lower than that in normal filling group （ P〈0.05）, but higher than that in the pseud- onormal filling group and restrictive filling group （ P〈0.05）. There was no difference in the ASR be- tween the relaxation drop and pseudo filling the normal groups （ P〉0.05）, and there was different among normal filling group, relaxation drop group and restrictive filling group （ P〈0.05）. There was no differ- ence in the SSR between normal and relaxation drop groups （ P 〉0.05）, and there was different among normal group, pseudonormal filling group and re- strictive filling group （ P 〈0.05）, and the SSR in pseudo-normal group was higher than that in the oth- er groups. Conclusion： Objective and quantitative e- valuation of left ventricular myocardial function chan ges in patients with abnormal filling patterns through the application of SRI, can provide quantitative indi- cators for clinical evaluation of the damage extent of left ventrieular diastolic function.