摘要
目的探讨超声左室无创压力-应变环对脓毒症患者左室收缩功能的临床评估价值。方法选择28例脓毒症患者及同期健康志愿者20例,所有受试者均行经胸超声心动图检查,脱机分析测量左室整体长轴应变(GLS)、整体做功指数(GWI)、整体有用功(GCW)、整体无用功(GWW)、整体做功效率(GWE)、纵向应变达峰时间离散度(PSD)。结果脓毒症患者的GLS明显低于对照组、PSD高于对照组(P<0.01),GWI、GCW、GWE均显著低于对照组,脓毒症患者左GWW高于对照组(P<0.01)。GLS、PSD、GWI、GCW、GWE、GWW左室收缩功能障碍的AUC分别为0.92、0.73、0.89、0.88、0.85、0.76。结论超声左室压力-应变环定量评估的左室心肌做功可敏感识别脓毒症患者早期左室收缩功能障碍,为临床评估提供更多参考信息。
Objective To explore the value of noninvasive pressure strain loop(PLS)in clinical evaluation of patients with sepsis induced left ventricular systolic dysfunction.Methods 28 patients with sepsis and twenty healthy controls were measured by echocardiography.The images were analyzed off-line to calculate the left ventricular global longitudinal strain(GLS),global myocardial work index(GWI),global constructive work(GCW),global wasted work(GWW),global myocardial work efficiency(GWE)and peak strain dispersion(PSD).Results The GLS of sepsis patients was significantly lower than that of the control group,and the PSD was higher than that of the control group(P<0.01).GWI,GCW and GWE were significantly lower than the control group,and GWW was higher than the control group(P<0.01).The AUC of GLS、PSD、GWI、GCW、GWE、GWW in the diagnosis of sepsis-induced left ventricular systolic dysfunction was 0.92、0.73、0.89、0.88、0.85、0.76.Conclusions The myocardial work which quantified by left ventricular pressure-strain loop can sensitively identify left ventricular systolic dysfunction in patients with sepsis,and provide more reference information for clinical evaluation.
作者
刘小禾
姝瓦克·达吾列提汗
王力军
董庆云
刘艳存
柴艳芬
Liu Xiaohe;Shu Wake·Dawulietihan;Wang Lijun;Dong Qingyun;Liu Yancun;Chai Yanfen(Department of Emergency,Tianjin Medical University General Hospital,Tianjin,China)
基金
北京协和医学基金会—睿E(睿意)急诊医学研究专项基金(项目编号:R2020010)
天津市卫生健康委员会科技项目(项目编号:ZC20188)
国家自然科学基金(项目编号:81871593)
天津市医学重点学科(专科)建设项目(项目编号:TJYXZDXK-007A)
关键词
脓毒症
超声心动图
心肌应变
左心室功能
Sepsis
Echocardiography
Myocardial strain
Left ventricular systolic function
