三维斑点追踪技术在主动脉瓣狭窄患者左心室收缩功能改变中的应用效果
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摘要
目的探讨三维斑点追踪技术在主动脉瓣狭窄患者左心室收缩功能改变中的应用效果。方法选取2017年10月～2018年8月我院收治的50例主动脉瓣狭窄患者作为研究对象,分别采用二维斑点追踪技术(对照组)、三维斑点追踪技术(观察组)进行心脏扫描。观察患者的超声心动图参数[左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、左室后壁舒张末期厚度(LVPWd)以及室间隔厚度(IVST)],对比两种技术的斑点追踪技术参数[左室整体面积应变(GAS)、左室整体环向应变(GCS)、左室整体长轴应变(GLS)、左室整体径向应变(GRS)、及三维应变(3D-strain)],对左室各整体应变值同LVEF、IVST的相关性进行分析。结果患者的LVEDD、LVESD、LVEF、LVPWd、IVST分别为(47.83±3.11)mm、(27.01±2.24)mm、(60.70±1.95)%、(10.62±0.75)mm、(12.63±0.90)mm;观察组患者的GAS、GCS均高于对照组,GLS、GRS低于对照组,差异有统计学意义(P<0.05);3D-strain为(32.60±4.54)%;GAS、GCS、GLS与LVEF成负相关,GRS、3D-strain与LVEF成正相关(P<0.05);GCS、GRS、3D-strain与IVST成负相关,GLS与IVST成正相关(P<0.05)。结论三维斑点追踪技术能够对主动脉瓣狭窄患者的左心室收缩功能改变情况进行准确评价,可为临床治疗方案的制定提供有价值的数据进行参考。
Objective To explore the effect of three-dimensional speckle tracking on left ventricular systolic function in patients with aortic stenosis.Methods A total of 50 patients with aortic stenosis treated in our hospital from October2017 to August 2018 were selected as the subjects,the two-dimensional speckle tracking technology(control group) and three-dimensional speckle tracking technology were used to perform a heart scan(observation group).Echocardiographic parameters(left ventricular end-systolic diameter [LVESD],left ventricular ejection fraction [LVEF],left ventricular posterior wall end-diastolic thickness [LVPWd],and ventricular septum thickness [IVST]) were observed.The speckle tracking technical parameters of the two techniques(left ventricular global area strain [GAS],left ventricular global circumferential strain [GCS],left ventricular global long axis strain [GLS],left ventricular global radial Strain [GRS] and three-dimensional strain [3 D-strain]) were compared.And the correlation between the overall strain values of the left ventricle and LVEF and IVST were analyzed.Results The VLEDD,LVESD,LVEF,LVPWd and IVST of patients were(47.83±3.11) mm,(27.01±2.24) mm,(60.70±1.95)%,(10.62±0.75) mm,and(12.63±0.90) mm,respectively.GAS and GCS of the observation group were higher than those of the control group,GLS and GRS were lower than those of the control group,and the differences were statistically significant(P<0.05),3 D-strain was(32.60±4.54)%.GAS,GCS,GLS and LVEF were negatively correlated.GRS and 3 D-strain were positively correlated with LVEF(P<0.05).GCS,GRS and 3 D-strain were negatively correlated with IVST,and GLS was positively correlated with IVST(P<0.05).Conclusion Three-dimensional speckle tracking technology can accurately evaluate the left ventricular systolic function changes in patients with aortic stenosis,and can provide valuable data for the development of clinical treatment plans for reference.
Objective To explore the effect of three-dimensional speckle tracking on left ventricular systolic function in patients with aortic stenosis.Methods A total of 50 patients with aortic stenosis treated in our hospital from October2017 to August 2018 were selected as the subjects,the two-dimensional speckle tracking technology(control group) and three-dimensional speckle tracking technology were used to perform a heart scan(observation group).Echocardiographic parameters(left ventricular end-systolic diameter [LVESD],left ventricular ejection fraction [LVEF],left ventricular posterior wall end-diastolic thickness [LVPWd],and ventricular septum thickness [IVST]) were observed.The speckle tracking technical parameters of the two techniques(left ventricular global area strain [GAS],left ventricular global circumferential strain [GCS],left ventricular global long axis strain [GLS],left ventricular global radial Strain [GRS] and three-dimensional strain [3 D-strain]) were compared.And the correlation between the overall strain values of the left ventricle and LVEF and IVST were analyzed.Results The VLEDD,LVESD,LVEF,LVPWd and IVST of patients were(47.83±3.11) mm,(27.01±2.24) mm,(60.70±1.95)%,(10.62±0.75) mm,and(12.63±0.90) mm,respectively.GAS and GCS of the observation group were higher than those of the control group,GLS and GRS were lower than those of the control group,and the differences were statistically significant(P<0.05),3 D-strain was(32.60±4.54)%.GAS,GCS,GLS and LVEF were negatively correlated.GRS and 3 D-strain were positively correlated with LVEF(P<0.05).GCS,GRS and 3 D-strain were negatively correlated with IVST,and GLS was positively correlated with IVST(P<0.05).Conclusion Three-dimensional speckle tracking technology can accurately evaluate the left ventricular systolic function changes in patients with aortic stenosis,and can provide valuable data for the development of clinical treatment plans for reference.
引文
[1]李丹.三维斑点追踪成像技术评价冠状动脉不同程度狭窄患者左心室收缩功能的研究[D].北京:中国人民解放军医学院,2016.
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[8]张艺,陈昕,张婷婷,等.二维斑点追踪技术评估慢性主动脉瓣反流患者的左心室收缩功能[J].中国超声医学杂志,2018,34(7):605-608.
[9]段宇龙,段峰,石真桂,等.二维斑点追踪技术对主动脉瓣狭窄患者瓣膜置换前后左心室收缩功能的评价作用研究[J].武警后勤学院学报(医学版),2015,24(10):789-791.
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[11]王子龙,杨性安,王刚,等.三维斑点追踪成像评估重度主动脉狭窄左心室纵向应变及扭转运动[J].心脑血管病防治,2018,18(5):371-373.
[12]陈丽萍,魏薪,冯沅,等.三维斑点追踪技术评价经导管主动脉瓣植入术患者左心室整体及局部收缩功能[J].中华超声影像学杂志,2014,23(10):829-834.
[13]张敏.4D应变评价射血分数正常的主动脉瓣狭窄及TAVI患者左室整体功能[D].上海:第二军医大学,2016.
[14]杜佳伟.斑点追踪显像技术评价主动脉瓣狭窄患者瓣膜置换术前后左心室收缩功能[D].锦州:辽宁医学院,2015.
[15]文鼎华.实时三维超声心动图评价主动脉瓣狭窄患者左心室功能及同步性[J].实用医技杂志,2018,25(10):1069-1071.
[16]田海燕,郭建东,张小杉.斑点追踪技术评价主动脉瓣狭窄瓣膜置换术前后左心室扭转功能[J].心血管康复医学杂志,2016,25(3):321-323.
[2]薛娜.RT3D-STI技术评价无RWMA冠状动脉狭窄患者左心室整体及局部舒张功能[D].承德:承德医学院,2016.
[3]陈莹.实时三维斑点追踪成像技术评价冠状动脉狭窄患者左心室整体及局部心肌收缩功能[D].承德:承德医学院,2015.
[4]张魁.实时三维超声心动图联合速度向量超声成像评价主动脉瓣狭窄左心室收缩同步性[D].泸州:泸州医学院,2014.
[5]闫晓妮,陈瑛,汪越君,等.三维斑点追踪技术对主动脉瓣狭窄患者亚临床左心室收缩功能受损的评价[J].中国医师杂志,2016,18(5):692-694.
[6]邓冰晴,王开权,李金国,等.三维斑点追踪技术对射血分数正常的重度主动脉瓣狭窄患者左室心肌收缩功能的评价效果[J].中国心血管病研究,2018,16(1):27-31.
[7]刘文旭,赵映,何怡华,等.二维斑点追踪技术评价不同程度主动脉瓣狭窄患者左心室收缩功能[J].心肺血管病杂志,2014,33(3):410-413.
[8]张艺,陈昕,张婷婷,等.二维斑点追踪技术评估慢性主动脉瓣反流患者的左心室收缩功能[J].中国超声医学杂志,2018,34(7):605-608.
[9]段宇龙,段峰,石真桂,等.二维斑点追踪技术对主动脉瓣狭窄患者瓣膜置换前后左心室收缩功能的评价作用研究[J].武警后勤学院学报(医学版),2015,24(10):789-791.
[10]丁钱山,张平洋,李林,等.三维斑点追踪技术评价射血分数正常的重度主动脉瓣狭窄患者左室心肌收缩特性[J].中国超声医学杂志,2017,33(2):128-131.
[11]王子龙,杨性安,王刚,等.三维斑点追踪成像评估重度主动脉狭窄左心室纵向应变及扭转运动[J].心脑血管病防治,2018,18(5):371-373.
[12]陈丽萍,魏薪,冯沅,等.三维斑点追踪技术评价经导管主动脉瓣植入术患者左心室整体及局部收缩功能[J].中华超声影像学杂志,2014,23(10):829-834.
[13]张敏.4D应变评价射血分数正常的主动脉瓣狭窄及TAVI患者左室整体功能[D].上海:第二军医大学,2016.
[14]杜佳伟.斑点追踪显像技术评价主动脉瓣狭窄患者瓣膜置换术前后左心室收缩功能[D].锦州:辽宁医学院,2015.
[15]文鼎华.实时三维超声心动图评价主动脉瓣狭窄患者左心室功能及同步性[J].实用医技杂志,2018,25(10):1069-1071.
[16]田海燕,郭建东,张小杉.斑点追踪技术评价主动脉瓣狭窄瓣膜置换术前后左心室扭转功能[J].心血管康复医学杂志,2016,25(3):321-323.