左室限制性充盈异常患者左房功能的研究

Assessment of left atrial function in patients with restrictive filling abnormalities of left ventricle

目的：探讨应变率成像技术（ SRI）评价左室限制性充盈异常患者左房功能的临床应用价值。方法将66例研究对象根据左室充盈模式分为正常充盈组和限制性充盈异常组，测量房间隔、左房前壁、下壁、侧壁、后壁收缩期应变率峰值（ SSR），舒张早期应变率峰值（ ESR），舒张晚期应变率峰值（ ASR），计算两组的平均SSR、ESR、ASR并分析比较；根据Simpson法测量左房最大容积（LAVmax）、最小容积（LAVmin）、收缩前容积（LAVp），计算左房射血分数（LAEF）、左房主动射血分数（LAAEF）、左房被动射血分数（LAPEF），同时计算左房主动射血容积指数（LAAEVI），左房被动射血容积指数（ LAPEVI），分析计算结果。结果限制性充盈异常组应变率值均小于正常充盈组，两组ESR、ASR、SSR比较差异均有统计学意义（P〈0.05）。限制性充盈异常组的左房功能均弱于正常充盈组，两组LAEF、LAAEF、LAPEF、LAAEVI 、LAPEVI比较差异均有统计学意义（P〈0.05）。正常充盈组ASR、SSR与LAEF及异常组SSR与LAEF呈负相关，正常充盈组ESR与LAEF及异常组ASR、ESR与LAEF呈正相关。结论应变率成像技术可定量评估左室限制性充盈异常模式左房功能的改变，间接反映左室舒缩功能的改变。

Objective To investigate the clinical application value of strain rate imaging（ SRI） on evaluating the left atrial function in patients with restrictive filling abnormalities of left ventricle. Methods Sixty-six subjects were divided into normal filling group and restrictive filling abnormalities group,according to different filling patterns of left ventricle. The strain rate values including peak systolic strain rate（ SSR）,early diastolic strain rate peak（ ESR）,late diastolic strain rate peak（ ASR）of atrial septum,left atrial anterior,inferior,lateral,posterior walls were measured,respectively. The aver-age SSR,ESR,ASR of the two groups were calculated and analyzed. The left atrial maximum volume （ LAVmax ）, the left atrial minimum volume （ LAVmin ）, the left atrial volume before contraction （ LAVp）were measured by Simpson method. The left atrial ejection fraction（ LAEF）,left atrial active ejection fraction（ LAAEF）,left atrial passive ejection fraction（ LAAEF）,left atrial active ejection volume index（ LAAEVI）,left atrial passive ejection volume index（ LAPEVI）were calculated and analyzed. Results The strain rate values in restrictive filling abnormalities group were less than those in normal filling group,there were significant differences in ESR,ASR,SSR between the two groups（P〈0. 05）. The left atrial function in restrictive filling abnormalities group were poorer than that in normal filling group, there were significant differences in LAEF,LAAEF,LAPEF,LAAEVI,LAPEVI between the two groups （P〈0. 05）. The indexes of ASR,SSR in normal filling group and SSR in restrictive filling group were negative correlated with LAEF,and the indexes of ESR in normal filling group and ASR,ESR in restrictive filling group were positive correlated with LAEF. Conclusions Strain rate imaging can quantitatively evaluate left atrial function changes in patients with restrictive filling abnormalities of left ventricle,and indirectly reflect the left ventricular systolic and diastolic function changes.