二维斑点追踪技术评价Child各级肝硬化患者左室功能指标的差异

Difference analysis of evaluating left ventricular function in patients with different Child grading of liver cirrhosis by two-dimensional speckle tracking technique

目的应用二维斑点追踪技术分析Child各级肝硬化患者左室功能指标的差异。方法选取120例肝硬化患者,根据不同Child分级分为A、B、C级三组,另选40例正常成人为对照组。应用二维斑点追踪技术获得各组左室16节段横纵及立体方向的最高收缩期测值,比较各组患者心室功能指标的差异。结果肝硬化患者收缩压、舒张压及脉压差均低于对照组,但心率高于对照组,差异均有统计学意义(均P<0.05)。除左室侧壁心尖节段的最高收缩期测值差异无统计学意义外,肝硬化患者左室其他节段横纵及立体方向的最高收缩期测值均低于对照组,差异均有统计学意义(均P<0.05);Child A、B、C级组患者左室心尖段、中间段及基底段的最高收缩期测值两两比较,差异均有统计学意义(均P<0.05)。结论肝硬化患者均有左室部分节段收缩力下降的并发症,Child分级越高,左室越多节段会出现收缩力下降,且其收缩力会进一步下降。

Objective To analyze the differences of evaluating left ventricular function in patients with different Child grading of liver cirrhosis by two-dimensional speckle tracking technique.Methods One hundred and twenty patients with cirrhosis were enrolled.According to Child grade,the patients were divided into A,B,C groups,while 40 healthy subjects were used as a control group.The highest systolic value of left ventricular 16 segments at horizontal,vertical and three-dimensional directions were obtained by two-dimensional speckle tracking technique.The differences of left ventricular function index in all groups were analyzed.Results The systolic pressure,diastolic pressure and pulse pressure of patients with liver cirrhosis were lower than those in control group,but the heart rate was higher（all P0.05）.In addition to the highest systolic value of apical segment of left ventricular lateral wall,the highest systolic values of left ventricular other segments at horizontal,vertical and three-dimensional directions in cirrhosis groups were lower than those in control group（all P0.05）.After each pairwise comparison of the maximum systolic value of apical segment,intermediate segment and basal segment of left ventricle from three experiment groups,there were significant differences（all P0.05）.Conclusion In patients with liver cirrhosis,there are complications of decreasing systolic function in the part segments of left ventricle.With the higher Child grade,more segments of left ventricle will reduce systolic function,and its systolic function will decline further.