摘要
目的应用三维斑点追踪技术(3D-STI)评价不同分期尘肺病患者右心室功能的变化情况。方法于2020年6月,收集114例尘肺病患者为研究对象,分为尘肺病壹期组45例,尘肺病贰期组36例,尘肺病叁期组33例,以同期50名健康体检者为对照组。采集并对比各组研究对象右心室游离壁中段以及基底段纵向收缩期峰值应变(LS)、径向收缩期峰值应变(RS)和圆周向收缩期峰值应变(CS),采用3D-STI计算并比较各组研究对象右心室整体纵向收缩期峰值应变(GLS)、右心室整体圆周收缩期峰值应变(GCS)、右心室射血分数(RVEF)、右心室整体径向收缩期峰值应变(GRS)、右心室面积变化率(FAC)、三尖瓣收缩期峰值速度(TVSPV)以及肺动脉收缩压(PASP)。结果尘肺病贰期组患者右心室游离壁基底段LS和RS明显低于对照组(P<0.0125),尘肺病叁期患者右心室游离壁基底段LS、CS、RS以及中间段RS明显低于对照组(P<0.0125);尘肺病壹期组患者右心室游离壁基底段LS、CS和RS均明显高于尘肺病叁期组(P<0.0125),尘肺病贰期组患者右心室游离壁基底段RS明显高于尘肺病叁期组(P<0.0125)。尘肺病贰期、叁期组患者RVEF和GLS水平明显低于对照组,PASP水平明显高于对照组(P<0.125);尘肺病叁期组患者FAC和TVSPV水平明显低于对照组(P<0.0125);尘肺病壹期组患者RVEF、GLS和FAC水平明显高于尘肺病叁期组(P<0.0125),PASP水平明显低于尘肺病叁期组(P<0.0125),尘肺病贰期组患者FAC水平明显高于尘肺叁期组(P<0.0125)。结论尘肺病患者早期可出现右心室功能下降,3D-STI可较为准确地检测右心室纵向、径向、圆周运动以及血流动力学改变,能够全面、客观地评估右心室功能,对早期发现尘肺病患者右心室功能不全具有重要意义。
Objective To evaluate the changes of right ventricular function in patients with pneumoconiosis in different stages using three-dimensional speckle-tracking imaging(3D-STI).Methods In June 2020,114 pneumoconiosis patients were selected as subjects,including 45 patients in stageⅠpneumoconiosis group,36 patients in stageⅡpneumoconiosis group and 33 patients in stageⅢpneumoconiosis group.Fifty healthy subjects were enrolled and served as control group.The longitudinal strain(LS),radial strain(RS)and circumferential strain(CS)of free wall middle and basal segment of right ventricular were collected and compared.The right ventricular global longitudinal strain(GLS),right ventricular global circumferential strain(GCS),right ventricular ejection fraction(RVEF),right ventricular global radial strain(GRS),the rate of fractional area change(FAC),the tricuspid valve systolic peak velocity(TVSPV)and the pulmonary artery systolic pressure(PASP)of each subject in the groups were collected and compared by 3D-STI.Results The LS and RS of the right ventricular basal segment of patients in stageⅡpneumoconiosis group were significantly lower than those of control group(P<0.0125).The LS,CS,RS of the right ventricular basal segment and RS of right ventricular middle segment of patients in stageⅢpneumoconiosis group were significantly lower than those of control group(P<0.0125).The LS,CS and RS of the right ventricular basal segment of patients in stageⅠpneumoconiosis group were significantly higher than those of stageⅢpneumoconiosis group(P<0.0125),and the RS of the right ventricular basal segment of patients in stageⅡpneumoconiosis group was significantly higher than that of stageⅢpneumoconiosis group(P<0.0125).The levels of RVEF and GLS of patients in stageⅡand stageⅢpneumoconiosis group were significantly lower than those of control group(P<0.0125),while the levels of PASP were significantly higher than that of control group(P<0.0125).The levels of FAC and TVSPV of patients in stageⅢpneumoconiosis group were significantly lower than those of control group(P<0.0125).The levels of RVEF,GLS and FAC of patients in stageⅠpneumoconiosis group were significantly higher those that of stageⅢpneumoconiosis group(P<0.0125),and the PASP level was significantly lower than that of stageⅢpneumoconiosis group(P<0.0125).The FAC level of patients in stageⅡpneumoconiosis group was significantly higher than that of stageⅢpneumoconiosis group(P<0.0125).Conclusion Patients with pneumoconiosis could experience a decline in right ventricular function at an early stage.The 3D-STI can accurately detect the GLS,GRS,GCS and hemodynamic changes of the right ventricular and evaluate the right ventricular function comprehensively and objectively.3D-STI is of great significance for the early detection of right ventricular dysfunction in patients with pneumoconiosis.
作者
潘少平
修海华
董志鹏
韩超
Pan Shaoping;Xiu Haihua;Dong Zhipeng;Han Chao(Department of Occupational Medicine,Yantai Yantaishan Hospital,Yantai 265000,China;Department of Internal Medicine,Haiyang Hospital of Traditional Chinese Medicine,Haiyang 265100,China)
出处
《中华劳动卫生职业病杂志》
CAS
CSCD
北大核心
2021年第8期586-589,共4页
Chinese Journal of Industrial Hygiene and Occupational Diseases
关键词
尘肺病
三维斑点追踪技术
右心室功能
Pneumoconiosis
Three-dimensional speckle tracking imaging
Right ventricular function
