二维超声斑点追踪成像技术评价肥厚型心肌病患者左心室功能的研究

Evaluation of left ventricular function of hypertrophic cardiomyopathy paients by two dimentional speckle tracking echocardiography

目的应用二维超声斑点追踪成像技术(2DSTE)评价肥厚型心肌病患者左心室功能,探讨其临床可行性。方法选择2015年7月~2016年6月新疆维吾尔自治区喀什地区第一人民医院(以下简称"我院")收治的肥厚型心肌病患者60例作为病例组,选择同期我院健康志愿者40例作为对照组,均行常规二维超声心动图(2DE)、2DSTE及心脏磁共振(CMR)检查,比较左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)和左心室射血分数(LVEF)水平,并分析各检测方法间相关性。结果病例组剔除3例图像质量较差患者,最终纳入患者57例。与CMR比较,2DE及2DSTE图像采集时间明显缩短,差异有统计学意义(P<0.05);3种方法图像分析时间比较,差异均有统计学意义(P<0.05)。组间比较显示,病例组LVEDV及LVESV水平均低于对照组,差异有统计学意义(P<0.05)。组内比较显示,病例组中,2DE LVEDV检测值明显低于CMR和2DSTE(P<0.05),3种方法间LVESV检测值差异均有统计学意义(P<0.05),2DSTE LVEF检测值明显低于CMR和2DE(P<0.05)。两组中2DSTE、2DE与CMR各检测指标均呈正相关关系(P<0.05)。结论肥厚型心肌病患者左心室容积明显低于正常人群,2DSTE各检测指标值与CMR存在高度相关性,且操作简单,耗时短,对肥厚型心肌病患者心功能检测具有独特优势,具有较好的临床应用前景。

Objective To discuss clinical feasibility of two dimentional speckle tracking echocardiography （2DSTE） by ap- plication for evaluation of left ventricular function of hypertrophic cardiomyopathy （HCM） paients. Methods 60 cases of patients with HCM in the First People＇s Hospital of Kashi in Xinjiang Uygur Autonomous Region （＂our hospial＂ for short） from July 2015 to June 2016 were selected as case gorup, while 40 healthy volunteers during the same time were se- lected as the control gorup. All of them were given two-dimensional echocardiography （2DE）, 2DSTE and cardiac mag- netic resonance （CMR） detection. The levels of LVESV, LVEDV and LVEF were compared, and the correlation among the three detection methods were analyzed. Results In the case gorup, 3 patients had poor image quality, 57 patients included in the case gorup ultimately. Compared with CMR, 2DE and 2DSTE had shorter image acquisition time （P 〈 0.05）, while image analysis time comparison, the three groups had statistically significant （P 〈 0.05）. Results of between-group comparison showed that, in the case gorup, the levels of LVEDV and LVESV were significantly lower than those of the control group （P 〈 0.05）. Results of intra-group comparison showed that, in the case gorup, the LVEDV level by 2DE de- tection was significantly lower than CMR and 2DSTE detection （P 〈 0.05）, the LVESV level had statistically significant differences among the three detection methods （P 〈 0.05）, the LVEF level by 2DSTE detection was significantly lower than CMR and 2DE detection （P 〈 0.05）. There were positive correlation among 2DSTE, 2DE and CMR detection in the two gorups （P 〈 0.05）. Conclusion The left ventricular volumes of HCM patients are significantly lower than normal, the parameter values by 2DSTE detecion have high correlation with CMR, with simple operation and shorter time. 2DSTE has unique advantage for heart function detection in HCM paients, which has preferable clinical application prospects.