| 向覃言秋,孙阳,王志刚,成涓.实时三维超声及斑点追踪技术评价非酒精性肝硬化患者左心房功能[J].中国医学影像技术,2018,34(2):232~236 |
| 实时三维超声及斑点追踪技术评价非酒精性肝硬化患者左心房功能 |
| Evaluation of left atrial function in non-alchoholic cirrhosis patients using real-time three-dimensional echocardiography and speckle tracking imaging |
| 投稿时间：2017-09-09 修订日期：2017-12-13 |
| DOI：10.13929/j.1003-3289.201709049 |
| 中文关键词: 超声心动描记术 肝硬化 心房功能,左 斑点追踪成像 |
| 英文关键词:Echocardiography Liver cirrhosis Atrial function, left Speckle tracking imaging |
| 基金项目:国家自然科学基金青年科学基金（81401423）、重庆市五大功能区域创新创业团队支持计划（渝科委发[2016]187号）。 |
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| 中文摘要: |
| 目的 应用实时三维超声（RT-3DE）及二维斑点追踪技术（2D-STI）评价非酒精性肝硬化患者左心房结构及功能变化。方法 收集非酒精性肝硬化患者60例，根据肝功能分为Child-Pugh A级、B级、C级3个亚组，并收集16名健康志愿者为对照组。采用RT-3DE测量左心房径线（LAD）、最大容积（LAVmax）、收缩前容积（LAVpre）、最小容积（LAVmin），计算左心房整体射血分数（LATEF）、扩张指数（LAEI）、主动射血分数（LAAEF）及被动射血分数（LAPEF）。采用STI测量左心房整体收缩期、舒张早期和舒张晚期平均峰值应变（mSs、mSe、mSa）及应变率（mSRs、mSRe、mSRa），计算左心房僵硬度（LASt）。结果 与对照组比较，Child-Pugh A级、B级、C级亚组LAD、LAVmax、LAVpre、LAVmin及LASt增高（P均<0.05）；Child-Pugh B级、C级亚组LAPEF、mSe、mSRe减低（P均<0.05）；Child-Pugh A级、B级亚组LATEF、LAEI、mSs、mSRs、LAAEF、mSa、mSRa增高（P均<0.05），C级亚组LATEF、LAEI、LAAEF增高（P均<0.05），mSs、mSRs减低（P均<0.05）。LASt与LAEI、mSs、mSRs、LAPEF、mSe、mSRe呈负相关，与LATEF、LAAEF、LAVmax、LAVpre、LAVmin、mSa、mSRa无明显相关。结论 非酒精性肝硬化患者左心房随肝功能恶化而出现不同程度功能障碍，RT-3DE和2D-ST技术可早期发现及评估左心房结构和功能异常。 |
| 英文摘要: |
| Objective To evaluate changes of left atrial (LA) structure and function in non-alchoholic cirrhosis patients with real-time three-dimensional echocardiography (RT-3DE) and two-dimensional speckle tracking imaging (2D-STI). Methods Totally 60 cirrhosis patients (cirrhosis group) and 16 healthy volunteers (control group) were enrolled, and the patients were divided into Child-Pugh A, B and C subgroup according to liver function. RT-3DE was used to obtain LA diameters (LAD), maximum volume (LAVmax), pre-contraction volume (LAVpre) and minimum volume (LAVmin). LA total emptying fraction (LATEF), expansion index (LAEI), active emptying fraction (LAAEF) and passive emptying fraction (LAPEF) were calculated. 2D-STI was used to measure mean peak longitudinal strain of LA in systolic, early-diastolic, end-diastolic phase (mSs, mSe, mSa)and strain rate of systolicm (mSRs, mSRe, mSRa), and LA stiffness (LAst) were calculated. Results Compared with those in control group, LAD, LAVmax, LAVpre, LAVmin and LAst increased in Child-Pugh A, B and C subgroup (all P<0.05), while LAPEF, mSe and mSRe decreased in Child-Pugh B and C subgroup (all P < 0.05), LATEF, LAEI, mSs, mSRs, LAAEF, mSa, mSRa increased in Child-Pugh A and B subgroup (all P<0.05). Child-Pugh C subgroup showed increased LATEF, LAEI, LAAEF and decreased mSs, mSRs (both P<0.05). LASt had negative correlation with LAEI, mSs, mSRs, LAPEF, mSe and mSRe, whereas no significant correlation was found between LASt and LATEF, LAAEF, LAVmax, LAVpre, LAVmin, mSa nor mSRa. Conclusion The dysfunction of LA varies with liver function in non-alcoholic cirrhosis patients. RT-3DE and 2D-STI can detect and evaluate dysfunction of LA in early stage. |
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