【摘要】：目的通過二維斑點追蹤技術(shù)獲取左室心肌縱向應(yīng)變,探討其對兒童川崎病急性期心肌損傷的診斷及預(yù)測價值。方法 60例KD急性期患者根據(jù)有無冠狀動脈擴張(CAE)分為無冠脈損傷組(B組)和冠脈損傷組(C組);選擇56例健康體檢兒童作為對照組(A組),采集研究對象心肌動態(tài)圖像,行二維超聲心動圖檢查,記錄心尖位左四腔觀、二腔觀及長軸觀圖像,使用Simpon法進行左室射血分數(shù)(LVEF)測量。應(yīng)用QLA10.0軟件對所采集的心肌圖像進行斑點追蹤并獲得左室二腔心(AP2LS)、三腔心(AP3LS)、四腔心(AP4LS)縱向應(yīng)變值及左室整體縱向應(yīng)變值(GLS),分析心肌運動情況。分別計算AP2LS、AP3LS、AP4LS及GLS判斷CAE的ROC曲線下面積(AUC),獲得鑒別CAE的最佳臨界值。結(jié)果 (1)常規(guī)超聲指標LVEF差異無統(tǒng)計學(xué)意義。(2)3組間及組間AP2LS、AP3LS、AP4LS及GLS比較差異均有統(tǒng)計學(xué)意義(P0.01)(3)AP2LS、AP3LS、AP4LS、GLS診斷CAE的AUC分別為0.68(95%CI:0.53~0.83),0.86(95%CI:0.74~0.98),0.82(95%CI:0.71~0.93),0.94(95%CI:0.88~1.00)。以AP2LS診斷CAE的AUC為對照,AP3LS、GLS與其比較差異有統(tǒng)計學(xué)意義(P0.05)。ROC曲線顯示GLS診斷CAE的敏感度為94%、特異度為90%,AP3LS診斷CAE的敏感度及特異度分別為74%和90%。結(jié)論二維斑點追蹤成像左室心肌縱向應(yīng)變技術(shù)可早期評估川崎病患兒心肌的受損情況。
[Abstract]:Objective to study the diagnostic and predictive value of left ventricular longitudinal strain in children with Kawasaki disease (Kawasaki disease). Methods Sixty patients with KD were divided into two groups according to coronary artery dilatation (CAE): no coronary artery injury group (group B) and coronary artery injury group (group C), 56 healthy children were selected as control group (group A), and myocardial dynamic images were collected. Left four-chamber view, two-chamber view and long-axis view were recorded by two-dimensional echocardiography. Left ventricular ejection fraction (LVEF) was measured by Simpon method. The left ventricular two-chamber heart (AP2LS), three-chamber heart (AP3LS), four-chamber heart (AP4LS) longitudinal strain and left ventricular global longitudinal strain (GLS) were obtained by using QLA10.0 software. The area under the ROC curve (AUC) of CAE was calculated by AP2LSU AP3LSU AP4LS and GLS, and the best critical value for CAE identification was obtained. Results (1) there was no significant difference in LVEF between three groups and among groups (P0.01) (P0.01). (3) the AUC of AP2LSU AP4LSLS in the diagnosis of CAE was 0.68 (95CI0.530.83) 0.86 (95CI0.740.98) 0.82 (95CI0.710.93) 0.94 (95CI0.881.00). Compared with AUC of CAE diagnosed by AP2LS, there was significant difference between GLS and GLS (P0.05) .ROC curve showed that the sensitivity of GLS in the diagnosis of CAE was 94%, the specificity was 90% and the sensitivity and specificity of GLS in the diagnosis of CAE were 74% and 90%, respectively. Conclusion the two-dimensional dot-tracing imaging left ventricular longitudinal strain technique can be used to evaluate myocardial damage in children with Kawasaki disease.
【作者單位】： 蘇州大學(xué)附屬第三醫(yī)院常州市第一人民醫(yī)院心功能科;蘇州大學(xué)附屬第三醫(yī)院常州市第一人民醫(yī)院兒科;蘇州大學(xué)附屬第三醫(yī)院常州市第一人民醫(yī)院心內(nèi)科;
【基金】：常州市科技局應(yīng)用基礎(chǔ)研究CJ20160030 常州市衛(wèi)計委重大課題ZD201407
【分類號】：R725.4
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本文編號：2135867