本文選題：病態(tài)竇房結綜合征 + 三維斑點追蹤成像��； 參考：《青島大學》2017年碩士論文

【摘要】：目的目前三維斑點追蹤成像技術(3D-STI)主要應用于評價心室結構及功能的變化,對于心房的評估臨床應用較少。病態(tài)竇房結綜合征為臨床常見的疾病之一,該疾病易并發(fā)多種房性心律失常,本研究通過三維斑點追蹤成像技術測量心房的容積大小評估心房的結構重構程度,測量心房肌的整體應變率評估患者是否存在心房運動失同步性,評估患者心房電重構的程度。方法收集青島大學醫(yī)學院附屬醫(yī)院于2014.12-2016.10月初次診斷為病態(tài)竇房結綜合征患者,根據(jù)是否合并慢快綜合征分為2組,第一組為合并慢快綜合征患者共25人(SSS1組),第二組為不合并慢快綜合征共25人(SSS2組),并取正常人25人作為對照組。測定并記錄所有患者左心房最大容積(LAVmax)、左心房最小容積(LAVmin)、左心房收縮前容積(LAVp),根據(jù)以上數(shù)據(jù)計算出左心房容積指數(shù)(LAVI)、左心房每搏量(LASV)、左心房被動射血分數(shù)(LAPEF)和左心房主動射血分數(shù)(LAAEF),同時測量右心房容積(RAV)并計算右心房容積指數(shù)(RAVI)。應用3D-STI技術獲取左房整體縱向應變(GLPS)、徑向應變(GRPS)、圓周應變(GCPS)、面積應變(GAPS)。記錄所有數(shù)據(jù),并應用SPSS17.0統(tǒng)計學軟件進行處理。通過以上指標評價心房失同步性及結構的重構程度,并比較重構程度是否與患者合并慢快綜合征有相關性。結果1.SSS1組與對照組相比較,LAVp增加(30.45±5.45vs 25.14±3.29),LAVI增加(31.39±5.83vs 29.72±2.84),LASV(27.83±8.11vs 30.25±2.54)、LAPEF(39.29±2.28vs50.39±3.84)、LAAEF(22.47±3.48vs31.74±2.59)均降低,差異具有統(tǒng)計學意義(P0.05);SSS2組與對照組相比較,LAVp增加(28.39±5.48vs 25.14±3.29),LAVI增加(31.29±3.29vs 29.72±2.84),LASV(28.02±3.53vs 30.25±2.54)、LAPEF(40.28±4.29vs50.39±3.84)、LAAEF(24.17±3.21vs31.74±2.59)均降低,差異具有統(tǒng)計學意義(P0.05),但SSS1組與SSS2組之間差異無統(tǒng)計學意義。2.SSS1組與對照組相比較,RAV(45.21±6.13vs36.50±4.60)、RAVI(23.96±1.87vs20.32±2.72)均增加,差異具有統(tǒng)計學意義(P0.05);SSS2組與對照組相比較,RAV(41.23±6.52vs36.50±4.60)、RAVI(23.05±3.52vs20.32±2.72)均增加,差異具有統(tǒng)計學意義(P0.05),但SSS1組與SSS2組之間無差異性。3.SSS1組、SSS2組、對照組三組相比,GLPS(24.52±2.35 vs 28.16±4.38 vs 30.46±5.02)、GRPS(23.54±4.65 vs 25.63±5.47 vs 28.82±6.15)、GCPS(17.52±3.58 vs19.89±5.23 vs23.15±4.08)、GAPS(50.72±5.65 vs54.38±7.25 vs 62.47±8.93)呈遞增趨勢,其中SSS1組最低,差異具有統(tǒng)計學意義(P0.05)。結論1、病態(tài)竇房結綜合征患者與健康人相比,存在心房的電重構和結構重構。2、病態(tài)竇房結綜合征患者中合并慢快綜合征的電重構的程度較不合并慢快綜合征的患者電重構的程度更加顯著。3、3D-STI可定量評估心房肌的結構及功能的改變,可填補常規(guī)超聲心動圖的不足,應用于臨床中,可對患者的評估更加及時、完善,為臨床早期干預病態(tài)竇房結綜合征的治療提供參考。
[Abstract]:Objective at present, 3D-STI is mainly used to evaluate the changes of ventricular structure and function. Sick sinus syndrome (SSS) is one of the most common clinical diseases, which is prone to multiple atrial arrhythmias. In this study, the volume size of atrium was measured by three dimensional speckle tracing imaging to evaluate the degree of atrial structural remodeling. The global strain rate of atrial muscle was measured to assess whether there was atrial motion loss and the degree of atrial electrical remodeling. Methods patients with sick sinus syndrome (SSS) were collected from affiliated Hospital of Qingdao University Medical College from April to early October, 2014.The patients were divided into two groups according to whether they were complicated with slow and fast syndrome. The first group consisted of 25 patients with chronic fast syndrome and 25 patients with chronic fast syndrome. The second group consisted of 25 patients without slow fast syndrome and 25 normal subjects as control group. We measured and recorded the left atrium maximal volume, left atrial minimum volume, left atrial presystolic volume and left atrial presystolic volume. Based on the above data, we calculated the left atrial volume index (LVI), left atrial volume (LASV), left atrial passive ejection fraction (LAPEF1) and left atrial ejection fraction (LAPEF1), based on the above data, we calculated the left atrial volume index (LAVI), left atrial volume (LASV), left atrial passive ejection fraction (LAPEF). Atrial active ejection fraction (LAAEFV) and right atrial volume (RV) were measured and the right atrial volume index (RIA) was calculated. 3D-STI technique was used to obtain the whole longitudinal strain of left atrium (GLPS), radial strain (GRPS), circumferential strain (GCPS) and area strain (GAPS). All data were recorded and processed by SPSS 17.0 statistical software. The above indexes were used to evaluate the degree of atrial loss and structural remodeling, and to compare the correlation between the degree of remodeling and the patients with slow fast syndrome. 緇撴灉1.SSS1緇勪笌瀵圭収緇勭浉姣旇緝,LAVp澧炲姞(30.45鹵5.45vs 25.14鹵3.29),LAVI澧炲姞(31.39鹵5.83vs 29.72鹵2.84),LASV(27.83鹵8.11vs 30.25鹵2.54),LAPEF(39.29鹵2.28vs50.39鹵3.84),LAAEF(22.47鹵3.48vs31.74鹵2.59)鍧囬檷浣，

本文編號：2001172