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目的应用二维超声斑点追踪成像技术(2DSTE)评价肥厚型心肌病患者左心室功能,探讨其临床可行性。方法选择2015年7月~2016年6月新疆维吾尔自治区喀什地区第一人民医院(以下简称“我院”)收治的肥厚型心肌病患者60例作为病例组,选择同期我院健康志愿者40例作为对照组,均行常规二维超声心动图(2DE)、2DSTE及心脏磁共振(CMR)检查,比较左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)和左心室射血分数(LVEF)水平,并分析各检测方法间相关性。结果病例组剔除3例图像质量较差患者,最终纳入患者57例。与CMR比较,2DE及2DSTE图像采集时间明显缩短,差异有统计学意义(P<0.05);3种方法图像分析时间比较,差异均有统计学意义(P<0.05)。组间比较显示,病例组LVEDV及LVESV水平均低于对照组,差异有统计学意义(P<0.05)。组内比较显示,病例组中,2DE LVEDV检测值明显低于CMR和2DSTE(P<0.05),3种方法间LVESV检测值差异均有统计学意义(P<0.05),2DSTE LVEF检测值明显低于CMR和2DE(P<0.05)。两组中2DSTE、2DE与CMR各检测指标均呈正相关关系(P<0.05)。结论肥厚型心肌病患者左心室容积明显低于正常人群,2DSTE各检测指标值与CMR存在高度相关性,且操作简单,耗时短,对肥厚型心肌病患者心功能检测具有独特优势,具有较好的临床应用前景。
Objective To evaluate left ventricular function in patients with hypertrophic cardiomyopathy by two-dimensional speckle tracking imaging (2DSTE) and to investigate its clinical feasibility. Methods From July 2015 to June 2016, 60 patients with hypertrophic cardiomyopathy who were admitted to the First People’s Hospital of Kashgar in Xinjiang Uyghur Autonomous Region (hereinafter referred to as “our hospital”) were selected as the case group, and healthy volunteers Forty as the control group. All patients underwent 2DE, 2DSTE and CMR examination. The left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV) and left ventricular ejection fraction Blood test (LVEF) levels, and analyze the correlation between test methods. Results In the case group, 3 patients with poor image quality were excluded, and finally 57 patients were enrolled. Compared with CMR, 2DE and 2DSTE image acquisition time was significantly shorter, the difference was statistically significant (P <0.05); three methods of image analysis time, the difference was statistically significant (P <0.05). The comparison between groups showed that the LVEDV and LVESV levels in the case group were lower than those in the control group, the difference was statistically significant (P <0.05). The intra-articular comparison showed that the 2DE LVEDV was significantly lower than the CMR and 2DSTE in the case group (P <0.05), and there was significant difference between the three methods in LVESV (P <0.05) and 2DSTE LVEF In CMR and 2DE (P <0.05). There was a positive correlation between 2DSTE, 2DE and CMR in both groups (P <0.05). Conclusions Left ventricular volume in patients with hypertrophic cardiomyopathy was significantly lower than that in normal subjects. The values of 2DSTE were highly correlated with CMR, and their operation was simple and time-consuming. They had unique advantages in detecting cardiac function in patients with hypertrophic cardiomyopathy. Good clinical application prospects.