超声二维斑点示踪技术原理及诊断儿童先天性心脏病的应用价值研究
摘要
目的在分析超声二维斑点示踪技术原理基础上,探讨其在先天性心脏病儿童早期诊断中的应用价值。方法选取120例先天性心脏病儿童为病例组,另选取100名健康体检儿童作为对照组。所有研究对象均监测血压指标、代谢指标及常规超声心动图评估左室整体收缩及舒张功能,并运用Qlab 8.1软件计算左心室二维斑点纵向、径向、周向应变参数。结果两组儿童三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、总胆固醇、糖化血红蛋白等指标比较,差异有统计学意义(P<0.05),两组儿童收缩压和舒张压比较,差异有统计学意义(P<0.01),但两组儿童左房内径、左室后壁厚度、室间隔舒张末厚度、二尖瓣口舒张早期最大血流速率、左室舒张末期内径、左室收缩末期内径、心房收缩期最大血流速率、二尖瓣室间隔基底内侧瓣环舒张早期峰值速度、舒张期晚峰值速度、左室射血分数等参数比较,差异无统计学意义(P>0.05)。病例组左室前壁、后壁、下壁、室间隔的纵向、径向、周向应变参数的绝对值低于对照组,差异有统计学意义(P<0.05);前壁、后壁、下壁和室间隔的纵向应变参数ROC曲线下面积均大于周向、径向应变参数ROC曲线下面积。结论二维斑点追踪成像技术可准确、客观地评价心室形态与功能,应用该技术可早期发现先天性心脏病儿童心室功能异常,在小儿先天性心脏病早期诊断中的具有较高的应用价值。
引文
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[2] 朱若燕,桂永浩,李丽蟾,等.三个心脏超声切面在常见先天性心脏病产前诊断中的作用[J].中华围产医学杂志,2016,9(6):404-408.
[3] 笪星星,刘雪松,王树超.急性颅脑外伤320例心电图分析[J].实用心电学杂志,2015,10(4):307-311.
[4] 中华医学会心血管病学会分.心血管疾病规范与共识[M].北京:中国医药科技出版社,2016:24-25.
[5] 余建洪,朱晓丽.ROC曲线评价4项指标对肺癌的鉴别诊断价值[J].检验医学与临床,2017,18(4):202-204.
[6] SEO J M,PAEK T H,LEE D Y,et al.Subclinical myocardial dysfunction in metabolic syndrome patients without hypertension[J].J Cardiovasc Ultrasound,2016,19(3):134-139.
[7] OYAMA M N,ISHINORI N,SUGIMORI H,et al.Dentification and further differentiation of subendo-cardial and transmural myocardial infarction by fast strain-encoded (SENC)magnetic resonance imaging at 3.0 tesla[J].Eur Radiol,2015,13(11):2362-2368.
[8] MARWICK T H,LEANO R L,BROWN J,et al.Myocardial strain measurement with 2-dimensional speckle-tracking e-chocardiography:definition of normal range[J].JACC Cardiovasc Imaging,2016,2(1):80-84.
[9] DELGADO V,YPENBURG C,ZHANG Q,et al.Changes in global left ventricular function by multidirectional strain assessment in heart failure patients undergoing cardiac resynchronization therapy[J].J Am Soc Echocardiogr,2016,22(6):688-694.
[10] 尹家保,郭瑞强,陈金玲,等.二维斑点追踪显像评价冠心病患者支架置入术前后左房功能的变化[J].中国超声医学杂志,2015,26(3):240-243.
[11] 李亚璞.VEGF、vWF与代谢综合征幼鼠及代谢综合征儿童心血管疾病危险的关系[D].天津:天津医科大学,2015.
[12] 张清友.抗凝药物华法林在儿童心血管疾病精准治疗的应用[J].中国实用儿科杂志,2016,11(2):208-211.
[13] 刘爽,马春燕,任卫东,等.超声二维斑点追踪技术评价缩窄性心包炎患者左房功能[J].中国超声医学杂志,2016,25(11):1034-1037.
[14] KARAYANNIS G,KITSIOS G,KOTIDIS H,et al.Left atrial remodelling contributes to the progression of asymptomatic left ventricular systolic dysfunction to chronic symptomatic heart failure[J].Heart Fail Rev,2015,13(1):91-98.
[15] 任卫东,刘爽,马春燕,等.二维斑点追踪技术评价心脏再同步化治疗对左心房功能的影响[J].中国医学影像技术.2016,12(9):1704-1707.
[16] KOKUBU N,YUDA S,TSUCHIHASHI K,et al.Noninvasive assessment of left atrial function by strain rate imaging in patients with hypertension:a possible beneficial effect of renin-angiotensin system inhibition on left atrial function[J].Hypertens Res,2015,30(1):1210-1218.