本文選題：硬化病 + 斑點追蹤成像�。� 參考：《川北醫(yī)學院》2015年碩士論文

【摘要】：目的:應用三維超聲斑點追蹤成像技術(shù)(3D-STI)評價系統(tǒng)性硬化病(SSc)患者左心室整體收縮功能,并探討各整體應變指標診斷SSc心臟損害的應用價值。方法:選取臨床確診SSc患者34例,其中彌漫皮膚型(dc SSc)18例,局限皮膚型(lc SSc)16例,正常健康對照組22例。采集標準心尖四腔心三維全容積圖像,運用3D-STI軟件脫機分析得出左心室整體面積收縮期峰值應變(GAS)、整體圓周收縮期峰值應變(GCS)、整體縱向收縮期峰值應變(GLS)、整體徑向收縮期峰值應變(GRS)及左心室射血分數(shù)(LVEF)等,比較SSc組與正常對照組各指標的變化情況。應用受試者操作特征(ROC)曲線分析各整體應變值對SSc患者左心室損害的診斷價值。結(jié)果:SSc組左心室GAS、GCS、GLS及GRS較正常對照組均減低(分別為-26.3±3.3%、-16.7±2.9%、-15.9±2.6%、40.7±8.3%對-31.1±2.8%、-18.5±2.5%、-19.2±1.8%、-46.4±10.3%),且差異有統(tǒng)計學意義(P均0.05);dc SSc組左心室GAS、GCS、GLS及GRS較lc SSc組均減低(分別為-25.1±3.3%、-15.9±2.7%、-15.0±2.4%、39.7±8.0%對-27.6±2.9%、-17.6±3.0%、-16.8±2.6%、41.8±8.8%),其中GAS和GLS差異有統(tǒng)計學意義(P0.05)。ROC曲線顯示GAS診斷SSc左心室損害的AUC最大,為0.877,當GAS截斷值為㧟29.34%時,其靈敏度為88.2%,特異度為77.3%。結(jié)論:SSc患者左心室縱向、環(huán)向及徑向收縮功能均已存在不同程度的受損,3D-STI可早期評價SSc患者的左心室整體收縮功能改變,在各項應變指標中,以GAS診斷SSc心臟損害的準確度最高。目的:應用二維斑點追蹤成像(2D-STI)技術(shù)評價系統(tǒng)性硬化病(SSc)患者右心室心肌功能的變化。方法:34例SSc患者,其中彌漫皮膚型(dc SSc)18例,局限皮膚型(lc SSc)16例,健康對照組22例,接受經(jīng)胸超聲心動圖檢查。應用2D-STI測量右心室側(cè)壁整體收縮期縱向峰值應變(GLS)及收縮期、舒張早期、舒張晚期整體縱向峰值應變率(GLSRs、GLSRe、GLSRa),比較SSc組與正常對照組及dc SSc組與lc SSc組各指標的變化情況。分析SSc組GLS與肺動脈收縮壓(PASP)及病程的相關性。結(jié)果:①SSc組與對照組比較,GLS、GLSRs及GLSRe均降低,且差異均有統(tǒng)計學意義(P均0.05),GLSRa無明顯差異;dc SSc組與lc SSc組比較,GLS、GLSRs及GLSRe均降低,其中GLS及GLSRe差異有統(tǒng)計學意義(P均0.05),GLSRa無明顯差異。②SSc組GLS與PASP及病程均呈負相關(r=-0.447,P=0.008;r=-0.500,P=0.003)。結(jié)論:SSc患者右心室收縮及舒張功能均降低,dc SSc患者較lc SSc患者受損更嚴重。2D-STI可準確評價右心室功能改變,其GLS與病程、PASP有一定的相關性。
[Abstract]:Objective: to evaluate the global systolic function of left ventricle in patients with systemic sclerosis (SSC) by using 3D ultrasonic speckle tracing imaging (3D-STI) and to evaluate the value of global strain indices in the diagnosis of SSc cardiac damage. Methods: 34 patients with SSc were selected, including diffuse skin type SSc)18, localized skin type SSc)16 and normal control group (22 cases). Three dimensional full-volume images of standard apical four-chamber heart were collected. 3D-STI software was used to analyze the peak systolic strain of left ventricular whole area (GASA), the peak strain of whole circumferential systolic period (GCSS), the peak strain of whole longitudinal systolic period (GLSN), the peak strain of global radial systolic period (GRS) and the left ventricular ejection fraction (LVEF), etc. The changes of each index in SSc group and normal control group were compared. The diagnostic value of global strain values for left ventricular damage in patients with SSc was analyzed by using the operating characteristics of subjects. 緇撴灉:SSc緇勫乏蹇冨GAS,GCS,GLS鍙奊RS杈冩甯稿鐓х粍鍧囧噺浣，

本文編號：1836262