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目的探讨三维斑点追踪技术在评价肝硬化患者右室心肌功能中的应用价值。方法将47例肝硬化患者按照Child-Pugh分级分为A、B、C三组,对照组为30例健康志愿者。应用三维斑点追踪技术(3D-STI)分析各组患者及对照组右心室整体面积应变(GAS)、各节段心肌峰值面积应变(AS)、心肌不同步指数(ASDI)及右室射血分数(RVEF)。结果A组各指标较对照组无明显差异,B组部分心肌节段AS、GAS、ASDI较对照组及A组增加(P<0.05),RVEF较对照组差异无统计学意义,C组部分心肌节段AS、GAS较对照组及A组减低(P<0.05),ASDI较对照组及A组增加(P<0.05),RVEF较对照组及A组明显减低(P<0.05)。结论肝硬化会引起右心室心肌损伤,超声斑点追踪技术可有效评价肝硬化不同阶段右心室心肌功能。
Objective To investigate the value of three-dimensional speckle tracking in assessing right ventricular myocardial function in patients with cirrhosis. Methods 47 patients with cirrhosis were divided into A, B and C groups according to Child-Pugh classification. The control group was 30 healthy volunteers. Three-dimensional speckle tracking (3D-STI) was used to analyze the changes of right ventricular mass area strain (GAS), peak myocardial area area (AS), ASDI and right ventricular ejection fraction (RVEF). Results There was no significant difference in each index between group A and control group. The AS, GAS and ASDI of some myocardial segments in group B were significantly higher than those in control group and group A (P <0.05), while there was no significant difference in RVEF between control group and group C The ASAS and GAS of the segments were lower than those of the control group and the A group (P <0.05). The ASDI of the ASAS group was higher than that of the control group and the A group (P <0.05). The RVEF was significantly lower than that of the control group and the A group (P <0.05). Conclusions Cirrhosis can cause right ventricular myocardial injury. Ultrasound speckle tracking can effectively evaluate the function of right ventricular myocardium at different stages of liver cirrhosis.