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  本文選題：超聲心動圖 + 斑點追蹤技術(shù)��； 參考：《中國醫(yī)科大學(xué)學(xué)報》2015年08期

【摘要】：目的探討二維斑點追蹤顯像評價左室旋轉(zhuǎn)和扭轉(zhuǎn)運動在早期心尖肥厚型心肌病(PAHCM)患者診斷過程中的準確性。方法選擇26例PAHCM患者、26例高血壓左心室肥厚(HLVH)患者和26例健康志愿者,分別行二維超聲心動圖檢查,記錄二尖瓣和心尖水平左室短軸及心尖四腔、二腔心切面的二維超聲圖像。使用QLAB 9.1軟件測量各短軸平面內(nèi)膜下心肌旋轉(zhuǎn)(endo-rot)、外膜下心肌旋轉(zhuǎn)(epi-rot)、跨壁扭轉(zhuǎn)(mural-tor)及平面旋轉(zhuǎn)(bulk-rot),計算出整體扭轉(zhuǎn)角度(G-tor)。篩選出診斷效力的指標,并繪制受試者工作特征(ROC)曲線來評價診斷的效果。結(jié)果在二尖瓣水平,PAHCM組與正常對照組相比,endo-rot、epi-rot、mural-tor及bulk-rot指標的差異無統(tǒng)計學(xué)意義(P0.05);PAHCM組與HLVH組相比,這些指標的差異有統(tǒng)計學(xué)意義(P0.05)。HLVH組與正常對照組相比,endo-rot、epi-rot、mural-tor及bulk-rot指標的差異有統(tǒng)計學(xué)意義(P0.05)。在心尖水平,3組間epi-rot的差異無統(tǒng)計學(xué)意義(P0.05)。PAHCM組與正常對照組相比,endo-rot、mural-tor及bulk-rot指標的差異有統(tǒng)計學(xué)意義(P0.05);PAHCM組與HLVH組相比,這些指標的差異有統(tǒng)計學(xué)意義(P0.05)。與正常對照組相比,HLVH組在endo-rot、mural-tor及bulk-rot指標上的差異有統(tǒng)計學(xué)意義(P0.05)。各組間G-tor的差異均有統(tǒng)計學(xué)意義(P0.05)。ROC曲線分析顯示,G-tor鑒別診斷PAHCM的準確性高(ROC曲線下的面積為0.89),敏感度為73.08%,特異度為92.31%。結(jié)論二維斑點追蹤顯像技術(shù)可以準確定量測量PAHCM患者左室心肌旋轉(zhuǎn)和扭轉(zhuǎn)的變化。使用G-tor可精確地識別和鑒別高血壓心肌肥厚和PAHCM。
[Abstract]:Objective to evaluate the diagnostic accuracy of left ventricular rotation and torsion motion in patients with early apical hypertrophic cardiomyopathy (PAHCM). Methods Twenty-six patients with hypertension and 26 patients with left ventricular hypertrophy (HLVH) and 26 healthy volunteers were examined by two dimensional echocardiography. Myocardial rotation (endo-rot), submembranous myocardial rotation (epi-rot), transmural torsion (mural-tor) and planar rotation (bulk-rot) were measured by QLAB9.1 software, and the global torsion angle (G-tor) was calculated. The diagnostic efficacy index was screened and the operating characteristics (ROC) curve was drawn to evaluate the diagnostic effect. Results there was no significant difference in the parameters of bulk-rot and bulk-rot between the PAHCM group and the normal control group (P0.05), and there was no significant difference between the PAHCM group and the HLVH group. There were significant differences between HLVH group and normal control group (P0.05). There were significant differences between HLVH group and normal control group (P0.05). There was no significant difference in epi-rot between the three groups at the apical level (P0.05). There were significant differences in the indexes of bulk-rot and epi-rot between the PAHCM group and the normal control group (P0.05). There was significant difference in these indexes between the PAHCM group and the HLVH group (P0.05). Compared with the normal control group, the difference of endo-rotator mural-tor and bulk-rot in HLVH group was statistically significant (P0.05). The difference of G-tor among groups was statistically significant (P0.05) .ROC curve analysis showed that G-tor differential diagnosis of PAHCM was accurate (the area under ROC curve was 0.89), sensitivity was 73.08 and specificity was 92.31. Conclusion Two-dimensional speckle tracing imaging can accurately and quantitatively measure the changes of left ventricular rotation and torsion in patients with PAHCM. High blood pressure myocardial hypertrophy and PAHCM can be accurately identified and distinguished by G-tor.
【作者單位】： 中國醫(yī)科大學(xué)附屬盛京醫(yī)院超聲科;
【基金】：遼寧省科技廳科學(xué)技術(shù)計劃項目(2013225049)
【分類號】：R445.1;R542.2

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本文編號：2117830