二維斑點追蹤成像技術(shù)評價妊娠高血壓孕婦左室功能改變的臨床應(yīng)用價值
發(fā)布時間：2019-03-27 14:52
【摘要】：目的應(yīng)用二維斑點追蹤成像(STI)技術(shù)對妊娠高血壓孕婦不同孕期左心室功能改變進行分析。方法選取妊娠高血壓組(PIH)48例,正常妊娠組45例,正常對照組45例,分別采集六組切面:心尖水平短軸切面、二尖瓣乳頭肌水平短軸切面、左室心底水平短軸切面、胸骨旁左室長軸切面、胸骨旁左心兩腔心切面、心尖四腔心切面,同步記錄心電圖,選取3-4個周期,導(dǎo)入QLAB工作站進行分析,記錄縱向運動應(yīng)變、徑向運動應(yīng)變、圓周運動應(yīng)變、旋轉(zhuǎn)運動應(yīng)變、縱向應(yīng)變率、徑向應(yīng)變率、圓周應(yīng)變率、旋轉(zhuǎn)應(yīng)變率及整體扭轉(zhuǎn)角度峰值(Ptw)、心底水平旋轉(zhuǎn)角度峰值(Prot-MV)、心底水平旋轉(zhuǎn)角度達峰絕對時間(Pti-MV)及達峰時間百分比(Perc-Pti-MV)、心尖水平旋轉(zhuǎn)角度峰值(Prot-AP)、心尖水平旋轉(zhuǎn)角達峰絕對時間(Pti-AP)及達峰時間百分比(Perc-Pti-AP)。結(jié)果1、妊娠高血壓組及正常妊娠組縱向運動應(yīng)變、徑向運動應(yīng)變、圓周運動應(yīng)變、旋轉(zhuǎn)運動應(yīng)變、縱向應(yīng)變率、徑向應(yīng)變率、圓周應(yīng)變率、旋轉(zhuǎn)應(yīng)變率均較對照組明顯減低(P0.05);妊娠高血壓組縱向運動應(yīng)變、徑向運動應(yīng)變、圓周運動應(yīng)變、旋轉(zhuǎn)運動應(yīng)變、縱向應(yīng)變率、徑向應(yīng)變率、圓周應(yīng)變率、旋轉(zhuǎn)應(yīng)變率均較正常妊娠組(P0.05);妊娠高血壓組晚期縱向運動應(yīng)變、徑向運動應(yīng)變、圓周運動應(yīng)變、旋轉(zhuǎn)運動應(yīng)變、縱向應(yīng)變率、徑向應(yīng)變率、圓周應(yīng)變率、旋轉(zhuǎn)應(yīng)變率低于中期(P0.05);2、妊娠高血壓組與正常妊娠組對比,妊娠高血壓組左室17節(jié)段中的12節(jié)段的心肌的面積峰值應(yīng)變減低,集中于下壁、室間隔及心尖部;3、Prot-AP、Pti-AP、Perc-Pti-MV、Perc-Pti-AP、Ptw在妊娠高血壓組及正常妊娠組孕中期水平高于正常對照組(P0.05),Prot-AP在妊娠高血壓組孕中、晚期水平高于正常妊娠組(P0.05)且Pti-AP、Ptw在妊娠高血壓組孕晚期水平高于正常妊娠組(P0.05),Prot-AP、Ptw在妊娠高血壓組孕晚期水平高于同組孕中期(P0.05),Pti-Mv在妊娠高血壓組及正常妊娠組孕中期水平低于正常對照組(P0.05)而Pti-AP在妊娠高血壓組及正常妊娠組孕中期水平高于正常對照組(P0.05),Perc-Pti-AP在妊娠高血壓組及正常妊娠組孕中期水平高于正常對照組(P0.05),而Perc-Pti-MV水平在兩組間孕中期比較無統(tǒng)計學(xué)差異;結(jié)論1.與正常孕婦組比較,LVEF正常的妊高癥孕婦左室收縮功能已經(jīng)發(fā)生改變,且隨著孕周的增大,收縮功能的減低更為明顯。2..2DSTI技術(shù)沒有角度依賴性,可重復(fù)性較好,測量過程也相對簡便,可以綜合評價左室收縮期縱向、徑向、圓周應(yīng)變及旋轉(zhuǎn)、扭轉(zhuǎn)角度的改變,從而更準(zhǔn)確地評價左室整體及局部心肌功能。
[Abstract]:Objective To analyze the changes of left ventricular function during pregnancy with two-dimensional spot-tracking imaging (STI) technique. Methods Forty-eight cases of pregnancy-induced hypertension (PIH),45 cases of normal pregnancy group and 45 cases of normal control group were divided into six groups: apical horizontal short axis section, mitral valve papillary muscle horizontal short axis section, left ventricular bottom horizontal short axis section, and left ventricular long axis section of the sternum. the heart-cutting surface of the left heart and the apical four-cavity heart-cutting surface beside the sternum are synchronously recorded, the electrocardiogram is synchronously recorded,3-4 cycles are selected, the QLAB working station is introduced for analysis, the longitudinal motion strain, the radial motion strain, the circular motion strain, the rotational motion strain, the longitudinal strain rate and the radial strain rate are recorded, the circumferential strain rate, the rotational strain rate, the total torsional angle peak (ptw), the bottom-bottom horizontal rotation angle peak (Prot-MV), the bottom-bottom horizontal rotation angle, the peak absolute time (Pti-MV), and the peak-to-peak time percentage (Perc-Pti-MV), the apex-level rotation angle peak (Prot-AP), Apex horizontal rotation angle peak absolute time (Pti-AP) and peak time percentage (Perc-Pti-AP). Results: The longitudinal movement strain, the radial movement strain, the circular motion strain, the rotational movement strain, the longitudinal strain rate, the radial strain rate, the circumferential strain rate and the rotational strain rate of the pregnancy and the normal pregnancy group were lower than that of the control group (P0.05). The longitudinal movement strain, the radial movement strain, the circular motion strain, the rotational movement strain, the longitudinal strain rate, the radial strain rate, the circumferential strain rate and the rotational strain rate of the pregnancy and hypertension group were higher than that in the normal pregnancy group (P0.05); and the late-stage longitudinal movement strain and the radial movement strain of the pregnancy and hypertension group, the circular motion strain, the rotational motion strain, the longitudinal strain rate, the radial strain rate, the circumferential strain rate and the rotational strain rate are lower than the middle term (P0.05); and 2, the pregnancy hypertension group is compared with the normal pregnancy group, The peak strain of the myocardium in the 12-segment of the left ventricular segment of the hypertensive group was lower than that in the lower wall, the interventricular septum and the apex.3, Prot-AP, Pti-AP, Perc-Pti-MV, Perc-Pti-AP and Ptw were higher than those in the normal control group (P0.05). The advanced level of Prot-AP in the pregnancy induced hypertension group was higher than that in the normal pregnancy group (P0.05), and the level of Pti-AP and Ptw in the pregnancy-induced hypertension group was higher than that in the normal pregnancy group (P0.05), and the prot-AP and Ptw were higher in the first trimester of pregnancy than in the same group (P0.05). The medium-term level of Pti-Mv in the pregnancy and the normal pregnancy group was lower than that of the normal control group (P0.05), while the medium-term level of the Pti-AP in the pregnancy and the normal pregnancy group was higher than that of the normal control group (P0.05), and the level of the Perc-Pti-AP in the pregnancy and the normal pregnancy group was higher than that in the normal control group (P0.05). The Perc-Pti-MV level was not statistically different between the two groups; Conclusion 1. Compared with the normal pregnant women group, the left ventricular systolic function of the normal pregnant women with LVEF has changed, and the reduction of the contraction function is more obvious with the increase of the gestational period. 2 DSTI has no angular dependence, the repeatability is good, the measurement process is relatively simple, the left ventricular systolic longitudinal, the radial, the circumferential strain and the rotation and the torsion angle can be comprehensively evaluated, so that the whole and the local myocardial function of the left ventricle can be more accurately evaluated.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R445.1;R714.246
本文編號：2448281
[Abstract]:Objective To analyze the changes of left ventricular function during pregnancy with two-dimensional spot-tracking imaging (STI) technique. Methods Forty-eight cases of pregnancy-induced hypertension (PIH),45 cases of normal pregnancy group and 45 cases of normal control group were divided into six groups: apical horizontal short axis section, mitral valve papillary muscle horizontal short axis section, left ventricular bottom horizontal short axis section, and left ventricular long axis section of the sternum. the heart-cutting surface of the left heart and the apical four-cavity heart-cutting surface beside the sternum are synchronously recorded, the electrocardiogram is synchronously recorded,3-4 cycles are selected, the QLAB working station is introduced for analysis, the longitudinal motion strain, the radial motion strain, the circular motion strain, the rotational motion strain, the longitudinal strain rate and the radial strain rate are recorded, the circumferential strain rate, the rotational strain rate, the total torsional angle peak (ptw), the bottom-bottom horizontal rotation angle peak (Prot-MV), the bottom-bottom horizontal rotation angle, the peak absolute time (Pti-MV), and the peak-to-peak time percentage (Perc-Pti-MV), the apex-level rotation angle peak (Prot-AP), Apex horizontal rotation angle peak absolute time (Pti-AP) and peak time percentage (Perc-Pti-AP). Results: The longitudinal movement strain, the radial movement strain, the circular motion strain, the rotational movement strain, the longitudinal strain rate, the radial strain rate, the circumferential strain rate and the rotational strain rate of the pregnancy and the normal pregnancy group were lower than that of the control group (P0.05). The longitudinal movement strain, the radial movement strain, the circular motion strain, the rotational movement strain, the longitudinal strain rate, the radial strain rate, the circumferential strain rate and the rotational strain rate of the pregnancy and hypertension group were higher than that in the normal pregnancy group (P0.05); and the late-stage longitudinal movement strain and the radial movement strain of the pregnancy and hypertension group, the circular motion strain, the rotational motion strain, the longitudinal strain rate, the radial strain rate, the circumferential strain rate and the rotational strain rate are lower than the middle term (P0.05); and 2, the pregnancy hypertension group is compared with the normal pregnancy group, The peak strain of the myocardium in the 12-segment of the left ventricular segment of the hypertensive group was lower than that in the lower wall, the interventricular septum and the apex.3, Prot-AP, Pti-AP, Perc-Pti-MV, Perc-Pti-AP and Ptw were higher than those in the normal control group (P0.05). The advanced level of Prot-AP in the pregnancy induced hypertension group was higher than that in the normal pregnancy group (P0.05), and the level of Pti-AP and Ptw in the pregnancy-induced hypertension group was higher than that in the normal pregnancy group (P0.05), and the prot-AP and Ptw were higher in the first trimester of pregnancy than in the same group (P0.05). The medium-term level of Pti-Mv in the pregnancy and the normal pregnancy group was lower than that of the normal control group (P0.05), while the medium-term level of the Pti-AP in the pregnancy and the normal pregnancy group was higher than that of the normal control group (P0.05), and the level of the Perc-Pti-AP in the pregnancy and the normal pregnancy group was higher than that in the normal control group (P0.05). The Perc-Pti-MV level was not statistically different between the two groups; Conclusion 1. Compared with the normal pregnant women group, the left ventricular systolic function of the normal pregnant women with LVEF has changed, and the reduction of the contraction function is more obvious with the increase of the gestational period. 2 DSTI has no angular dependence, the repeatability is good, the measurement process is relatively simple, the left ventricular systolic longitudinal, the radial, the circumferential strain and the rotation and the torsion angle can be comprehensively evaluated, so that the whole and the local myocardial function of the left ventricle can be more accurately evaluated.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R445.1;R714.246
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