Objective To evaluate the left ventricular remodeling in children with simple obesity quantitatively using three dimensional speckle tracing imaging (3D-STI).Methods From May 2017 to October 2018,43 obese children were selected as an obese group,and 38 overweight children as an overweight group;45 healthy children who had normal physical examination in the same period were selected as a control group.The left ventricular end-systolic volume (LVESV),left ventricular end-diastolic volume (LVEDV),left ventricular ejection fraction (LVEF),left ventricular global longitudinal strain (GLS),left ventricular global circumferential strain (GCS),and left ventricular global radial strain (GRS) were examined by two-and three-dimensional echocardiography,and compared among the three groups.The correlation of 3D-STI parameters with BMI and left ventricular mass (LVM) was analyzed by Pearson.Results The BMI,systolic blood pressure,LVESV,LVEDV and LVM were significantly higher while the GLS,GRS,and GCS were significantly lower in the obesity group and the overweight group than in the control group (all P ＜ 0.05).The GCS was significantly lower in the obese group than in the overweight group (P ＜ 0.05).Pearson correlation analysis showed that GLS,GRS and GCS positively correlated with BMI and LVM (all P ＜ 0.01).Conclusions 3D-STI can be used to evaluate the changes of the systolic function of children with simple obesity.Its sensitivity in assessing early myocardial changes is higher than two-dimensional echocardiography's.%目的 对单纯性肥胖症儿童采用三维斑点追踪成像技术(3D-STI)定量评估,探讨3D-STI对患儿左室心肌重构的评估价值.方法 选取2017年5月至2018年10月在本院因肥胖就诊的43例肥胖儿童为肥胖组,38例超重儿童为超重组;选取同期体检正常的45例健康儿童为对照组;采用二维及三维超声心动图检查,比较3组左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)、左室射血分数(LVEF)、左室整体纵向应变(GLS)、左室整体圆周应变(GCS)、左室整体径向应变(GRS)之间的差异;Pearson分析3D-STI参数与体质量指数(BMI)、左室质量(LVM)的关系.结果 肥胖组、超重组BMI、收缩压、LVESV、LVEDV、LVM均明显高于对照组,而GLS、GRS、GCS则均明显低于对照组(均P＜0.01);肥胖组GCS也明显低于超重组(P＜0.05);Pearson相关性分析结果显示GLS、GRS、GCS与BMI、LVM均呈正相关(均P＜0.01).结论 3D-STI能较为全面地评估单纯性肥胖患儿的心脏收缩功能变化,其评估心肌早期改变的敏感度高于二维超声心动图.
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