斑点追踪下肝硬化失代偿期患者心肌力学同步性特性变化

Changes of Myocardial Mechanics Synchronization in Patients with Decompensated Cirrhosis under Spot Tracking

目的对比研究肝硬化失代偿期患者心肌力学同步性。方法方便选取2018年2月—2019年4月临床确诊失代偿期患者66例为病例组,健康对照组30名。应用二维斑点追踪成像技术(2D-STI)获取左室各节段室壁心肌不同步指标。结果①左房内径(LAD),正常组均数(32.23±4.15)mm,异常组均数(36.27±5.38)mm;主动脉瓣口血流速度(AV),正常组均数(1.22±0.15)m/s,异常组均数(1.52±0.10)m/s、二尖瓣口舒张晚期峰值血流速度(MVA)E/e,正常组均数(3.20±1.3),异常组均数(7.27±4.00),较正常组增大,左室射血分数(EF)正常组均数(66.40±5.53)%,异常组均数(61.23±6.62)%减小(P<0.05),②左心室同步性统计分析:径向应变上左心室多个室壁节段性运动不同步RTmax PW,Post,正常组均数(427.56±85.26)ms,异常组均数(369.62±49.41)ms;Inf正常组均数(429.27±74.26)ms,异常组均数(362.54±77.35)ms;长轴应变MV(ant正常组均数(451.61±44.38)ms,异常组均数(408.67±68.42)ms,sept正常组均数(433,.24±63.29),异常组均数(405.28±57.53)ms PW:(antsept正常组均数(441.28±58.55)ms,异常组均数(365.25±53.27)ms,inf正常组均数(433.63±48.21)ms,异常组均数(374.86±65.25)ms等差异有统计学意义(P<0.05)。结论失代偿期肝硬化患者左室心肌部分节段性运动不同步,心功能一定程度受损,功能下降。

Objective Comparative study of myocardial mechanical synchrony in patients with decompensated cirrhosis.Methods From February 2018 to April 2019,66 cases of decompensated patients were convenient included in the case group and 30 cases in the healthy control group.Two dimensional speckle tracing imaging(2D-STI)was used to obtain the myocardial dyssynchrony index of the ventricular wall in each segment of the left ventricle.Results 1.Left atrial diameter(LAD),mean of normal group(32.23±4.15)mm,mean of abnormal group(36.27±5.38)mm;aortic valve flow velocity(AV),mean of the normal group:(1.22±0.15)mm,mean of the abnormal group:(1.52±0.10)m/s,mean of the late diastolic peak flow velocity(MVA)E/e,mean of the normal group:(3.20±1.3),mean of the abnormal group:(7.27±4.00),higher than the normal group,mean of the normal group,mean of the normal group:(66.40±5.53)%,the mean of the abnormal group decreased by(61.23±6.62)%(P<0.05).2.Left ventricular synchrony statistical analysis:radial strain on the left ventricle multi-wall segmental movement dyssynchrony RT max PW(Post normal group:(427.56±85.26)ms,abnormal group:(369.62±49.41)ms,Inf,normal group:(429.27±74.26)ms,abnormal group:(362.54±77.35)ms.Long-axis strain MV(ant)normal group mean(451.61±44.38)ms,abnormal group mean(408.67±68.42)ms,septs normal group mean(433,.24±63.29)ms,abnormal group mean(405.28±57.53)ms.PW:(antsepts)normal group mean(441.28±58.55)ms,the mean of the abnormal group was(365.25±53.27)ms,inf the mean of the normal group was(433.63±48.21)ms,and the mean of the abnormal group was(374.86±65.25)ms(P<0.05).Conclusion In decompensated cirrhosis patients,segmental dyssynchrony of left ventricular myocardium was observed,and cardiac function was impaired and decreased to some extent.