肺心病患者左心室功能的应变率成像分析

摘要

Objective To investigate the value of left ventricular function in patients with chronic pulmonary heart disease(CPHD) using strain rate imaging (SRI).Methods This study included 64 patients with CPHD (30 patients with compensatory function and 34 with decompensatory function) and 30 normal control.Peak systolic strain rate (SRs),peak early diastolic strain rate (SRe) and peak late diastolic strain rate (SRa)of left ventricular basal and middle segments were measured,and then mean peak strain rate (mSR) was calculated.The above digital parameters were analyzed compared with the conventional echocardiographic indices.Results The indices (mSRs,mSRe,mSRe/mSRa)in CPHD were reduced and mSRa increased as compared with those in controls (all P=0.000).And the above indices showed the same change when decompensatory group was compared with compensatory group (P=0.000,0.038,0.015,0.001).Negative correlation was noted between LVEF and mSRs in patients with CPHD (r=0.75,0.82;P=0.000).Conclusions LVEF is negatively related with mSRs in CPHD patients.mSRs can reflect the status of left ventricular function.SRI is a more sensitive tool in quantitative evaluation of left function of CPHD.%目的 探讨应变率成像(SRI)技术评价慢性肺心病患者左室功能的价值. 方法 选取慢性肺心病患者64例(其中代偿组30例,失代偿组34例)及健康对照组30例,应用SRI技术测量左室各壁基底段、中段的心肌收缩期峰值应变率(SRs)、舒张早期峰值应变率(SRe)和舒张晚期峰值应变率(SRa),计算左室平均峰值应变率(mSR),并与常规超声心动图指标进行对比研究. 结果与健康对照组相比,慢性肺心病组mSRs、mSRe、mSRe/mSRa均降低,mSRa均增高(均P=0.000).且与代偿组比较,失代偿组mSRs、mSRe、mSRe/mSRa降低,mSRa增高(P=0.000、0.038、0.015、0.001).慢性肺心病组左室射血分数(LVEF)与mSRs呈高度负相关(r=0.75、0.82,P=0.000).结论 慢性肺心病组LVEF与mSRs具有高度相关性,利用慢性肺心病患者左心室mSRs可以反映LVEF的状况.SRI技术较常规超声心动图更敏感、快速地定量评价慢性肺心病患者左心功能.