新生儿高胆红素血症左心室心肌收缩功能评估中二维斑点追踪显像技术的应用价值

Application value of two-dimensional speckle tracking imaging technique in the assessment of left ventricular myocardial systolic function in neonatal hyperbilirubinemia

目的探讨新生儿高胆红素血症左心室心肌收缩功能评估中二维斑点追踪显像技术的应用价值。方法选择吉林大学第一医院2020年8月至2021年12月收治的112例高胆红素血症儿为患儿组;同期抽取医院健康出生的120例足月新生儿为健康组。2组均以超声实施左心室功能检查,统计分析超声心动图与二维斑点追踪成像指标在不同组间的差异,以评价二维斑点追踪显像技术的应用优势。结果患儿组左心室流出道最大流速为(0.60±0.08)m/s,明显高于健康组(0.51±0.05)m/s(t=10.348,P=0.001)。患儿组左心室间隔三层心肌,室前壁与下壁的外膜下心肌、中层心肌的纵向峰值应变率与健康组比较差异均有统计学意义(P<0.05);患儿组心尖段外膜下心肌,中间段与基底段的外膜下心肌、中层心肌的纵向峰值应变率与健康组比较均有统计学意义(P<0.05)。患儿组治疗后心尖段与基底段外膜下心肌应变率分别为(-15.81±2.65)%、(-8.81±1.65)%,均小于治疗前(-14.93±2.72)%、(-8.03±1.86)%(t=2.452、3.320,P=0.015、0.001)。结论二维斑点追踪显像技术能够更为准确、灵敏地量化评价高胆红素血症患儿左心室心肌不同分层、不同室壁、不同节段的纵向应变指标差异,值得临床选择。

Objective To analyze the application value of two-dimensional speckle tracking imaging technique in the assessment of left ventricular myocardial systolic function in neonatal hyperbilirubinemia.Methods A total of 112 children with hyperbilirubinemia admitted from August 2020 to December 2021 in the First Hospital of Jilin University were selected as the children group.120 full-term neonates born in the hospital during the same period were selected as the healthy group.The left ventricular function was examined by ultrasound in both groups,and the differences between echocardiography and two-dimensional speckle tracking imaging between different groups were statistically analyzed to evaluate the application advantages of two-dimensional speckle tracking imaging technology.Results The maximum flow velocity of left ventricular outflow tract in the children group was(0.60±0.08)m/s,which was significantly higher than that in the healthy group(0.51±0.05)m/s(t=10.348,P=0.001).The longitudinal peak strain rates of the left ventricular septal three-layer myocardium,the subadventitial myocardium and the middle myocardium of the anterior and inferior ventricular walls in the child group were statistically significant compared with those in the healthy group(P<0.05).There was statistical significance in the comparison of the subepicardial myocardial strain parameters between the two groups,as well as the subepicardial myocardial strain parameters between the middle segment and the base segment(P<0.05).The myocardial strain rates in apical segment and basal segment were(-15.81±2.65)%and(-8.81±1.65)%,respectively,higher than those before treatment(-14.93±2.72)%and(-8.03±1.86)%(t=2.452,3.320,P=0.015,0.001).Conclusion Two-dimensional speckle tracking imaging technology can more accurately and sensitively quantitatively evaluate the differences in longitudinal strain indexes of left ventricular myocardium in different layers,walls,and segments in children with hyperbilirubinemia,and is worthy of clinical choice.