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目的应用二维斑点追踪成像技术定量分析健康儿童左心室收缩期心肌纵向应变及应变率,并进行其不同年龄段正常参考值的初步分析。方法回顾性分析2015年9月至2016年11月来本院超声科体检的330例健康儿童的超声临床资料。按年龄分成7组,分为新生儿组(0~28 d)、婴儿组(>28 d至<1岁)、幼儿组(1~<3岁)、学龄前期组(3~<6岁)、学龄期组(6~<9岁)、青春前期组(9~<13岁)、青春期组(13~<18岁)。采用斑点追踪软件分析左心室心尖3个长轴切面的动态图像,获取左心室收缩期心肌纵向应变及应变率值。结果 (1)6室壁节段间收缩期纵向应变及应变率的差异均有统计学意义(P<0.05),且纵向应变及应变率绝对值自基底段向心尖段呈逐渐增加趋势;(2)18节段应变及应变率及整体应变在不同性别间差异均无统计学意义(P>0.05);(3)除后壁、下壁、后间隔基底段外,余各室壁节段纵向应变(longitudinal strain,LS)情况为|LS_(新生儿组)|<|LS_(婴儿组)|<|LS)(幼儿、学龄前期、学龄期组)|<|LS_(青春前期、青春期组)|,且整体心肌纵向应变在年龄组间的趋势与其一致;(4)18节段应变与年龄呈正相关,以侧壁心尖段相关性最强(r=0.551,P<0.01);与心率均呈负相关,以侧壁中间段相关性最强(r=-0.517,P<0.01);整体心肌纵向应变与年龄呈正相关(r=0.665,P<0.01),与心率呈负相关(r=-0.625,P<0.01)。(5)18节段应变率与年龄、心率的相关性,以及在各年龄组间的差异存在不均一性。结论建立了不同年龄段健康儿童左心室收缩期心肌纵向应变及应变率的正常参考值,并发现其具有自身特征。
Objective To quantitatively analyze the longitudinal strain and strain rate of left ventricular systolic myocardium in healthy children by two-dimensional speckle tracking imaging and analyze its normal reference values at different ages. Methods The clinical data of 330 healthy children who underwent physical examination in our hospital from September 2015 to November 2016 were retrospectively analyzed. They were divided into 7 groups according to their age: neonatal group (0-28 d), infants (> 28 d to <1 year old), infant group (1-3 years old), preschool group (3-6 years old) , School-age group (6 ~ <9 years), pre-adolescent group (9 ~ <13 years), adolescent group (13 ~ <18 years). Dynamic tracking of left ventricular apex with three long axes was performed by speckle tracking software to measure left ventricular systolic myocardial longitudinal strain and strain rate. Results (1) There were significant differences in longitudinal strain and strain rate between systolic and diastolic segments of 6 wall segments (P <0.05), and the absolute value of longitudinal strain and strain rate increased gradually from basal segment to apical segment. 2) There was no significant difference in strain and strain rate and overall strain in 18 segments between different genders (P> 0.05). (3) Except for posterior wall, inferior wall and posterior septal basement, LS (Neonatal) | <| LS_ (Neonatal) | <| LS) (Preschool, Preschool, School Age) | <| LS_ (Preteen, Preadolescent Group) ), And the overall longitudinal strain of the myocardium was consistent with that of the age group. (4) The strain of 18 segments was positively correlated with age, the strongest correlation was found at the apical segment of the lateral wall (r = 0.551, P <0.01) (R = -0.517, P <0.01). The global myocardial longitudinal strain was positively correlated with age (r = 0.665, P <0.01), and negatively correlated with heart rate (r = -0.625, P <0.01). (5) The correlation between strain rate of 18 segments and age and heart rate, as well as the heterogeneity among different age groups. Conclusion The normal reference values of longitudinal strain and strain rate of left ventricular systolic myocardium in healthy children of different ages were established and found to have their own characteristics.