摘要
目的探讨我国0～18岁正常儿童左心室局部心肌收缩期纵向峰值应变率及其与年龄、心率的关系,以及不同年龄组正常儿童收缩期纵向峰值应变率特征。方法获取并存储164例0～18岁正常儿童胸骨旁心尖水平四腔、两腔及三腔观连续3个心动周期二维动态图像,应用GEEchoPAC软件分析并得到左心室各节段收缩期纵向峰值应变率(SrL)测值,并与年龄及心率进行回归分析。将164例正常儿童分为五组,幼儿组24例(A组,0～2岁),学龄前组32例(B组,3～5岁),学龄期组33例(C组,6～9岁),青春前期组19例(D组,10～13岁),青春期组56例(E组,13～18岁),比较各年龄组左心室各节段局部收缩期纵向应变率特征。结果 (1)正常儿童左心室局部心肌SrL的特征:左心室壁共18个节段的纵向应变率曲线形态相似。同一室壁心尖段SrL大于对应室壁基底段及中间段,左心室前壁各节段间SrL差异无统计学意义(P>0.05),其余室壁心尖段与基底段和(或)中间段比较差异有统计学意义(P<0.05)。(2)除前壁中间段SrL与年龄无关以外,其余节段与年龄和心率相关,其中年龄对后间隔中间段SrL影响最大(R2=0.377),心率对前间隔中间段SrL影响最大(R2=0.196)。(3)不同年龄组正常儿童左心室局部心肌SrL比较:SrL测值随年龄增长大致呈递减趋势;E组除前壁中间段及侧壁中间段以外,其余节段SrL测值小于A组(P<0.05);D组室间隔、下壁各节段SrL测值小于A组(P<0.05)。(4)观察者内变异系数6.3%,观察者间7.8%。结论正常儿童左心室壁各节段纵向应变率曲线形态一致,表明正常儿童左心室局部心肌纵向方向运动一致。不同年龄组正常儿童左心室局部心肌纵向功能分布存在不均一性,主要体现为幼儿组与青春期组之间的差异,但随年龄增长具有一定的规律,所以在运用斑点追踪技术评价正常儿童左心室纵向峰值应变率时需考虑年龄及心率的影响因素。
Objective To establish characteristics of peak systolic longitudal strain rate(SrL) in healthy children,and evaluate the relationship between age and SrL,also,assess the effect of heart rate on SrL in healthy children.Methods Transthoracic two-dimensional echocardiographic examinations were performed on a total of 164 healthy children.164 healthy children were divided into 5 groups:classing 0 to 2 years old children together as group A,and 3 to 5 years old as group B,6 to 9 years old as group C,10 to 12 years old as group D,13 to 18 years old as group E.Left ventricular apical four-chamber,three-chamber,two-chamber views were performed,and the dynamic 2-dimensional gray images in 3 heart cycles were obtained.All images were analysed off-line in GE EchoPAC workstation and regional longitudinal strain rate were acquired,and then analysed the relationship between regional strain rate and age,heart rate by regression analysis.Results(1)The characteristic of regional SrL in normal children:The shapes of the SrL curves of the left ventricular regional myocardium are similar.The apical SrL of left ventricular wall were larger than the middle one and the basal one.Significant differences were found between apical and basal or middle segments in left ventricular walls except anterior wall.(2)The strongest correlations of regional SrL were the middle posterior septum with age(R2=0.377) and the middle inferior segment with heart rate(R2=0.226),whereas other segments except the middle anterior wall have weaker correlations with age and heart rate.(3)These parameters of the five groups for SrL trend to decrease as well as the growth of age.SrL in group A were larger than group E except the middle segments of anterior and lateral wall.Significant difference for SrL was found between group D and group A in septum and inferior wall.(4)Intra-observer variability and the inter-observer variability were 6.3% and 7.8%.Conclusions The shapes of the regional longitudinal strain rate curves of the left ventricular regional myocardium were similar,which show that the motion of regional left ventricular myocardium are in the same direction.The parameters of SrL are heterogeneous in healthy children at different age stages,the differences are mainly between infant and adolescent,which imply that when we evaluate the regional longitudinal strain rate in children by speckle tracking echocardiography,age and heart rate effects must be considered.
出处
《中华临床医师杂志（电子版）》
CAS
2011年第23期6884-6891,共8页
Chinese Journal of Clinicians(Electronic Edition)
