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目的探讨三维斑点追踪超声心动图成像(3D-STE)整体面积应变(GAS)早期检测Duchenne型肌营养不良(DMD)患儿亚临床左室收缩功能损伤的可行性及临床意义。方法选取51例DMD患儿及31例正常对照儿童。应用二维及三维超声心动图检查获得左心室二维及三维左心室射血分数(LVEF)以及左室GAS。比较两组左心室收缩功能指标的差异。结果 DMD组与正常对照组的二维超声心动图指标差异无统计学意义(均P>0.05)。与正常对照组相比,DMD组三维容积指标及左室射血分数无明显变化(均P>0.05),而GAS显著减低(-26.5±5.8vs-30.7±4.05,P<0.01),差异有统计学意义。结论三维面积应变可定量评估DMD患儿左心室收缩功能,早期检测出DMD患儿的左室收缩功能损伤,为临床对DMD患儿心脏功能损伤的早期干预和判断预后提供有价值的参考。
Objective To investigate the feasibility and clinical significance of early detection of subclinical left ventricular systolic dysfunction in children with Duchenne muscular dystrophy (DMD) by three-dimensional speckle tracking echocardiography (3D-STE) whole area strain (GAS). Methods 51 children with DMD and 31 normal children were enrolled. Left ventricular two-dimensional and three-dimensional left ventricular ejection fraction (LVEF) and left ventricular GAS were obtained by two-dimensional and three-dimensional echocardiography. Differences in left ventricular systolic function between the two groups were compared. Results There was no significant difference in the two-dimensional echocardiographic parameters between DMD group and normal control group (all P> 0.05). Compared with the normal control group, the three-dimensional volume index and the left ventricular ejection fraction did not change significantly in DMD group (all P> 0.05), while the GAS was significantly lower (-26.5 ± 5.8 vs -30.7 ± 4.05, P <0.01) Statistical significance. Conclusion Three-dimensional area strain can quantitatively assess left ventricular systolic function in children with DMD and early detection of left ventricular systolic dysfunction in children with DMD. It provides a valuable reference for early intervention and prognosis of cardiac dysfunction in children with DMD.