超声二维应变成像技术评价男性饮酒对左心室收缩功能的影响

摘要

Objective To observe the impact of drinking on left ventricular systolic function of males with two-dimensional strain imaging (2DSI). Methods Forty normal adult males were enrolled as the control group (group A). Eighty-six chronic alcohol abusers were divided into 3 groups: group B (n=31), who consumed ≥90 g ethanol or 2 to 3 bottles (1100-1650 ml) beer daily for 5 to 8 years, 3 to 5 days per week; group C (n=34), who consumed ≥90 g ethanol or 2 to 3 bottles (1100-1650 ml) beer daily for 9 to 20 years, 3 to 5 days per week; group D (n=21), who consumed≥150 g ethanol or≥4 bottles (≥2200 ml) beer daily for more than 10 years, 6 to 7 days per week, consistent with diagnostic criteria of alcoholic cardiomyopathy. The parameters of the conventional echocardiography and 2DSI were obtained, including left ventricular end diastolic diameter (LVDd), left ventricular end systolic diameter (LVDs), interventricular septum thickness at end-diastole (IVSTd), posterior wall thickness at end-diastole (PWTd), left ventricular ejection fraction (LVEF) and E/A. Results ①No statistical difference of the longitudinal two-dimensional peak systolic strain and radial two-dimensional peak systolic strain of left ventricular short-axis was found between group B and A (all P＞0. 05). Compared with group A and B, parameters in all section of group C decreased remarkably (all P＜0. 05). Compared with group A, B and C, parameters in all section group of D lowered down obviously (all P＜0. 05). ②The conventional echocardiographic parameters were not statistically different between group A and B (all P＞0. 05). Compared with group A and B, no difference was found in group C except E/A (all P＜0. 01). The conventional echocardiographic parameters in group D were significantly different from those in group A, B and C (all P＜0. 05). Conclusion 2DSI can evaluate the impact of drinking on left ventricular systolic function of males, especially the early change of left ventricular systolic function.%目的 应用超声二维应变成像(2DSI)评价男性饮酒对左心室收缩功能的影响.方法 A组为40名非习惯性饮酒成年男性(A组).将86例男性饮酒者分为三组:B组31例,每日饮啤酒2～3瓶(1100～1650 ml)或白酒≥90 g(即纯乙醇75 ml),每周3～5天,时间5～8年;C组34例,饮酒量同B组,时间9～20年;D组21例,每日饮啤酒≥4瓶(≥2200 ml)或白酒≥150 g(即纯乙醇125 ml),每周6～7天,饮酒史10年以上,符合ACM诊断标准.对四组进行常规超声和2DSI检查并测定左心室舒张末期内径(LVDd)、收缩末期内径(LVDs)、舒张末期室间隔厚度(IVSTd)、舒张末期左心室后壁厚度(PWTd)、左心室射血分数(LVEF)和E/A.结果 心尖二维纵向收缩期峰值应变和左心室短轴心肌二维径向收缩期峰值应变各组间比较:B组与A组比较差异无统计学意义(P均＞0.05);C组与A组和B组比较,所有节段心肌收缩期峰值应变明显减低(P均＜0.05);D组与A组、B组、C组比较,所有节段心肌收缩期峰值应变显著降低(P均＜0.05).各常规超声参数B组与A组间差异无统计学意义(P均＞0.05);C组除舒张功能参数E/A与A组及B组差异有统计学意义(P均＜0.01)外,其余参数均无统计学意义;D组各常规超声参数与A组、B组和C组间差异均有统计学意义(P均＜0.01).结论 2DSI能够有效评估男性饮酒对左心室收缩功能的影响,尤其是早期左心室收缩功能的改变.