基于心脏磁共振的高原与平原患者心脏结构与功能对比分析教学研究

Teaching Research on Comparative Analysis of Cardiac Structure and Function for the Patients in the Plateau and Plain Based Region via Cardiac Magnetic Resonance Imaging

目的 通过心脏磁共振(CMR)的量化评价,开展高原患者与平原患者心脏结构及功能对比分析,为临床提供有效的教学方法。资料与方法 通过教学医院帮带,回顾性分析解放军联勤保障部队第九四五医院2022年1月16日—4月16日高原急下平原(高原组,47例)和世居平原(平原组,24例)的门诊患者共71例,应用黑血、电影、灌注等MRI序列,通过CMR进行患者心脏功能的影像学评估,并测量与心脏结构和心脏功能相关的24个参数,比较两组间各参数的差别。结果 心脏结构测量参数方面,两组患者差异均无显著统计学意义(均P>0.01)。心脏功能测量参数方面,高原组与平原组相比:左心室舒张末期容积(t=3.48,P<0.01)、左心室收缩末期容积(t=2.67,P<0.01)、左心室心肌质量(t=2.86,P<0.01)、右心室舒张末期容积(t=3.03,P<0.01)、右心室收缩末期容积(t=4.74,P<0.01)、右心室收缩末期容积/体表面积(t=4.33,P<0.01)显著升高;右心室射血分数(t=4.49,P<0.01)、右心室心指数(t=3.09,P<0.01)显著降低。结论 本研究通过CMR的量化评价方法,有效开展高原患者与平原患者心脏结构及功能对比分析的教学,为临床高原性心脏病准确诊断打下基础。

Purpose To provide the effective methods for clinical teaching on comparative analysis of cardiac structure and function for the patients in the plateau and plain through the quantitative evaluation of cardiac magnetic resonance imaging (CMR).Materials and Methods Outpatients of rush entry into plain from the plateau (plateau group,n=47) and native plain (plain group,n=24) were retrospectively enrolled in the 945^(th) Hospital of the United Logistics Force from January 16 to April 16 in 2022 through the help of teaching hospital.A total of 24 cardiac structure and cardiac function parameters were quantitatively measured and analyzed via CMR protocols including black blood,film,perfusion sequences.Results There were no significant difference in cardiac structure measurement parameters between the two groups (all P>0.01).There were significant differences between the two groups,increasing in left ventricular end diastolic volume (t=3.48,P<0.01),left ventricular end systolic volume (t=2.67,P<0.01),left ventricular myocardial mass (t=2.86,P<0.01),right ventricular end diastolic volume (t=3.03,P<0.01),right ventricular end systolic volume (t=4.74,P<0.01) and right ventricular end systolic volume/body surface area (t=4.33,P<0.01),while decreasing in right ventricular ejection fraction (t=4.49,P<0.01) and right ventricular heart index (t=3.09,P<0.01).Conclusion In this study,through the quantitative evaluation method of CMR,the teaching of comparative analysis of cardiac structure and function for patients in the plateau and plain region based on CMR is proposed,which lays a foundation for accurate diagnosis of plateau heart disease in clinical practice.