三维斑点追踪显像技术对肥厚型心肌病患者左室收缩不同步性的评价效果

The effect of dimensional speckle tracking imaging in evaluating left ventricular systolic dyssynchrony of hypertrophic cardiomyopathy patients

目的：观察三维斑点追踪显像（3D-STI）技术对肥厚型心肌病患者的左室不同步性评价效果。方法选取2012年3月~2014年8月来我院就诊治疗的86例肥厚型心肌病患者，根据其分型分为梗阻组（26例）和非梗阻组（60例），同时选取我院同期体检中心健康体检者40例作为对照组，比较三组患者的基本情况，常规超声及三维斑点追踪显像结果差异。结果三组患者的一般情况差异无统计学意义（P ＞0.05）；梗阻组和非梗阻组患者较对照组受检者在 IVSD、LVPWD、E/Ea、LVOT-PG、SV 指标上具有统计学差异，同时梗阻组患者与非梗阻组患者 IVSD、LVPWD、Ea/Aa、E/Ea 比较差异有统计学意义（P ＜0.05）；在三维斑点追踪显像结果上，非梗阻组与对照组在除外 TCS-SD%的数据上均具有统计学差异，梗阻组较对照组的所有指标均差异显著，而梗阻组与非梗阻组在除外 TLS-SD%、TLS-diff%的数据差异均有统计学意义（P＜0.05）。结论三维斑点追踪显像技术能较好地观察分析肥厚型心肌病患者的左室收缩不同步现象，为评价肥厚型心肌患者心室收缩异常提供了一种新的可供选择的检查方式。

Objective To observe the effect of dimensional speckle tracking imaging in evaluating left ventricular systolic dyssynchrony of hypertrophic cardiomyopathy patients. Methods 86 hypertrophic cardiomyopathy patients were selected in our hospital from March 2012 to August 2014, according to their classification into obstruction group（26 cases） and non-obstructive group （60 cases）, at the same time, 40 healthy cases in our hospital medical center over the same period were selected as the control group, comparing the differences of the basic situation, the conventional three-dimensional ultrasound speckle tracking imaging results of the three groups. Results The general conditions of 3 groups were not statistically significant（P 〉 0.05）; Obstruction group with non-obstructive group comparing to control group had a significant difference on the IVSD, LVPWD, E/Ea, LVOT-PG, SV, obstruction group comparing with non-obstructive group had a statistically significant difference on IVSD, LVPWD, Ea/Aa, E/Ea （P 〈 0.05）; as to the three-dimensional speckle tracking imaging results, non-obstructive group and control group were statistically different except in TCS-SD% data, obstruction group and control group were significantly different on all indicators, while obstruction group and non-obstructive group except for the TLS-SD%, TLS-diff% of the data were significantly different（P 〈 0.05）. Conclusion Three-dimensional speckle tracking imaging can better observe and analyze hypertrophic cardiomyopathy patients on left ventricular systolic dyssynchrony phenomenon, and provides a new way of checking to choose for the evaluation of ventricular contraction abnormalities in patients with hypertrophic cardiomyopathy.