| 崔艳华,严继萍,赵文莉,张全斌,蔚俊丽.三维斑点追踪成像评价急性一氧化碳中毒患者左心室收缩功能[J].中国医学影像技术,2019,35(6):848~852 |
| 三维斑点追踪成像评价急性一氧化碳中毒患者左心室收缩功能 |
| Three-dimensional speckle tracking imaging in evaluation on left ventricular systolic function of patients with acute carbon monoxide poisoning |
| 投稿时间：2018-09-28 修订日期：2019-03-03 |
| DOI：10.13929/j.1003-3289.201809148 |
| 中文关键词: 一氧化碳中毒 心室功能,左 三维斑点追踪成像 |
| 英文关键词:carbon monoxide poisoning ventricular function, left three-dimensional speckle tracking imaging |
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| 中文摘要: |
| 目的 采用三维斑点追踪成像（3D-STI）技术评价急性一氧化碳中毒对左心室收缩功能的影响。方法 将109例急性一氧化碳中毒患者（研究组）分为轻（n=36）、中（n=40）及重度（n=33）亚组，于中毒后1 h、1周进行3D-STI检查，并检测碳氧血红蛋白（HbCO）和血清心肌肌钙蛋白I（cTnI）浓度；以105名健康志愿者为对照组。分析研究组与对照组各检测指标的差异及相关性。结果 急性一氧化碳中毒1 h，轻度亚组与对照组整体长轴应变（GLS）、整体面积应变（GAS）、整体圆周应变（GCS）、整体径向应变（GRS）及左心室射血分数（LVEF）差异无统计学意义（P均>0.05），轻度亚组HbCO、cTnI均较对照组升高（P均<0.05），中度亚组GLS、GAS较对照组降低（P均<0.05），HbCO、cTnI较对照组升高（P均<0.05）；重度亚组GLS、GAS、GCS、GRS、LVEF较对照组降低（P均<0.05），HbCO、cTnI较对照组升高（P均<0.05）。急性一氧化碳中毒后1周，轻、中度亚组与对照组GLS、GAS、GCS、GRS、LVEF、HbCO及cTnI差异无统计学意义（P均>0.05）；重度亚组GAS较对照组降低（P<0.05），cTnI较对照组升高（P<0.05）。急性一氧化碳中毒1 h，研究组血清cTnI与GLS、GAS呈负相关（r=-0.626、-0.640，P均<0.05）。结论 3D-STI可早期诊断急性一氧化碳中毒引起的左心室收缩功能损害；GAS随血清cTnI含量升高而降低，是反映急性一氧化碳中毒左心室功能损害的较好指标。 |
| 英文摘要: |
| Objective To evaluate the impact of acute carbon monoxide poisoning on left ventricular systolic function with three-dimensional speckle tracking imaging (3D-STI). Methods Totally 109 patients with acute carbon monoxide poisoning (study group) were enrolled and divided into mild (n=36), moderate (n=40) and severe (n=33) subgroups. And 105 healthy volunteers were selected as control group. 3D-STI was performed 1 hour and 1 week after poisoning, respectively. The levels of carboxyhemoglobin (HbCO) and serum cardiac troponin I (cTnI) were measured. The difference and correlation of the indexes were analyzed between the study group and the control group. Results One hour after acute carbon monoxide poisoning, no significant difference of global longitudinal strain (GLS), global area strain (GAS), global circumferential strain (GCS), global radial strain (GRS) nor left ventricular ejection fraction (LVEF) was found between mild subgroup and control group (all P>0.05), while HbCO and cTnI in mild subgroup were higher than those in control group (both P<0.05), GLS and GAS in moderate subgroup were lower than those in control group (both P<0.05), and HbCO, cTnI were higher than those in control group (both P<0.05), GLS, GAS, GCS, GRS and LVEF in the severe subgroup were lower than those in control group (all P<0.05), HbCO and cTnI were higher than those in the control group (both P<0.05). One week after acute carbon monoxide poisoning, there was no significant difference of GLS, GAS, GCS, GRS, LVEF, HbCO nor cTnI among the mild, moderate subgroups and the control group (all P>0.05); GAS in severe subgroup was lower than that in control group (P<0.05), cTnI was higher than that in control group (P<0.05). One hour after acute carbon monoxide poisoning, serum cTnI was negatively correlated with GLS and GAS in the study group (r=-0.626, -0.640, both P<0.05). Conclusion 3D-STI can early diagnose damage of left ventricular systolic dysfunction caused by acute carbon monoxide poisoning. GAS decreases with the increase of serum cTnI content, which is a good indicator of left ventricular dysfunction in patients with acute carbon monoxide poisoning. |
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