2D-STI对舒张性心力衰竭患者左心室心肌收缩功能的评估价值

Value of 2D-STI in evaluating left ventricular systolic function in patients with diastolic heart failure

目的探讨超声二维斑点追踪技术(2D-STI)评估舒张性心力衰竭(DHF)患者左心室心肌收缩功能的临床价值。方法将2012年12月至2014年12月于我科接受治疗的120例DHF患者作为DHF组,以120例健康者作为正常组。利用常规超声对两组人群进行评估,同时应用2D-STI软件自动将各室壁等分为基底段、中间段、心尖段,同法分析心尖四腔心切面、心尖两腔心切面,共得到18个心肌节,分析两组受检者纵向和径向各18心肌节段收缩期峰值应变。结果正常组与DHF组患者在舒张末期左心室最大内径分别为(4.75±0.48)d/cm和(5.16±0.64)d/cm,收缩末期左心房最大内径分别为(3.61±0.53)d/cm和(3.99±0.81)d/cm,差异均有统计学意义(P<0.05);在心室舒张早期,正常组与DHF组患者二尖瓣口血流峰速(E)分别为(76.44±14.11)v·cm-1·s-1和(64.27±14.72)v·cm-1·s-1,E/A比值为(1.18±0.26)和(0.84±0.31),差异均有统计学意义(P<0.05);与正常组比较,DHF组患者左室18节段的径向和纵向收缩期峰值应变有明显降低趋势,差异具有统计学意义(P<0.05)。结论 2D-STI可以准确定量评估舒张性心力衰竭患者左心室心肌收缩功能,对临床工作具有指导意义。

Objective To evaluate the clinical value of two dimensional speckle tmcking imaging(2D-STI) in evaluating left ventricular systolic function in patients with diastolic heart failure(DHF). Methods A total of 120 patients with DHF who received treatment in our department from December 2012 to December 2014 were enrolled as DHF group, and 120 healthy subjects were selected as normal group. Subjects of two groups were evaluated by conventional ultrasound. 2D-STI software was used to divide the chamber wall into basal segment, middle segment and apical segment. The apical four chamber view and the apical two chamber view were analyzed by the same method, and 18 myocardial segments were obtained. The systolic peak values of longitudinal and radial direction of the 18 myocardial segments in two groups were analyzed. Results The left ventricular end-diastolic diameter(LVEDD) in normal group and DHF group were respectively(4.75 ± 0.48) d/cm and(5.16 ± 0.64) d/cm, and left atrium end-systolic diameter(LVESD) were(3.61±0.53) d/cm and(3.99±0.81) d/cm, and the differences were statistically significant(P<0.05). During the early ventricular diastole, the mitral blood flow peak velocity(E) in normal group and DHF group were respectively(76.44±14.11) v· cm-1· s-1and(64.27±14.72) v· cm-1· s-1, and E / A ratio were(1.18±0.26) and(0.84±0.31), with statistically significant differences(P<0.05). Compared with the normal group, the systolic peak values of longitudinal and radial direction of the 18 myocardial segments in DHF group were significantly decreased, and the differences were statistically significant(P<0.05). Conclusion 2D-STI can accurately assess left ventricular myocardial systolic function in patients with diastolic heart failure, which has guiding significance for clinical work.