摘要
目的应用二维斑点追踪成像评估新生足月儿与早产儿的左心室心肌应变,比较两者左心室功能的差异。资料与方法回顾性分析2018年2—8月在苏州大学附属儿童医院行超声心动图检查的正常新生儿81例(足月儿42例、早产儿39例),应用二维斑点追踪成像测量其左心室心肌各节段纵向峰值应变、各节段圆周峰值应变、左心室平均整体纵向峰值应变(GLPS-avg)及左心室平均整体周向峰值应变(GCPS-avg),并测量左心室射血分数(LVEF-M、LVEF-Simpson)、左心室短轴缩短率(LVFSM)、左心室舒张末期内径(LVEDD)和二尖瓣环室间隔侧舒张早、晚期运动速度(E′、A′)及早、晚期运动速度比值(E′/A′),比较足月儿与早产儿左心室应变及常规超声心动图参数的差异。结果足月儿与早产儿的GLPS-avg、心尖二腔切面纵向峰值应变(GLPS-a2c)、GCPS-avg、中段及心尖段圆周峰值应变(GCPS-M及GCPS-A)差异有统计学意义(t=-3.60~-2.18,P均<0.05),四腔切面及三腔切面纵向峰值应变(GLPS-a4c及GLPS-a3c)、基底段圆周峰值应变(GCPS-M)差异无统计学意义(P均>0.05)。早产儿GLPS-a4c、GLPS-a2c、GLPS-a3c差异有统计学意义(F=3.20,P=0.044),其中GLPS-a4c最高;GCPS-B、GCPS-M、GCPS-A差异有统计学意义(F=79.15,P<0.001)。足月儿GCPS-B、GCPS-M、GCPS-A差异有统计学意义(F=97.95,P<0.001),自基底段至心尖段应变值增高。两组常规超声心动图参数中LVEDD差异有统计学意义(P<0.05),LVEF-M、LVFS-M、LVEFSimpson、E′、A′、E′/A′差异无统计学意义(P>0.05)。结论二维斑点追踪成像是一种新的评估左心室收缩功能的方法,可以早期发现早产儿与足月儿左心室功能的差异。
Purpose To use two-dimensional speckle tracking imaging(2D-STI)to evaluate left ventricular myocardial strain in term and preterm neonates.Materials and Methods A total of 81 neonates who accepted echocardiography in Soochow University Affiliated Children's Hospital from February to August 2018 were retrospectively enrolled,including 42 term neonates and 39 preterm neonates.Longitudinal and circumferential peak strain of each segment of left ventricle were measured by 2D-STI,and the average global longitudinal peak strain(GLPS-avg)and the average global circumferential peak strain(GCPS-avg)of left ventricular were measured too.Left ventricular ejection fraction(LVEF-M,LVEF-Simpson),short-axis shortening rate(LVFS-M),left ventricular end-diastolic diameter(LVEDD),and tissue Doppler imaging parameters(E′,A′and E′/A′)of the septal mitral annulus were also measured.The differences in each segment of left ventricle and echocardiography between term neonates and preterm neonate were further compared.Results There were statistically significant differences in GLPS-avg,the global longitudinal peak strain from the apical two-chamber view(GLPS-a2c),GCPS-avg and the global circumferential peak strain in the middle and apical segments(GCPS-M ang GCPS-A)(t=-3.60--2.18,all P<0.05)between term neonates and preterm neonates,while there were no significant differences between the global longitudinal peak strain from the apical four-chamber and three-chamber view(GLPS-a4c and GLPS-a3c),the global circumferential peak strain in the basal segments(GCPS-M)(all P>0.05).There were statistically significant differences in GLPS-a4c,GLPS-a2c,GLPS-a3c in preterm neonates group(F=3.20,P=0.044),and the strain value GLPS-a4c was the highest.There were statistically significant differences in GCPS-B,GCPS-M,GCPS-A in preterm neonates group(F=79.15,P<0.001).There were statistically significant differences in GCPS-B,GCPS-M,GCPS-A in term neonates group(F=97.95,P<0.001),and the strain value increased from the basal segment to the apical segments.There was statistically significant difference in LVEDD between term neonates and preterm neonates(all P<0.05).There were no statistically significant differences in LVEF-M,LVEF-Simpson,LVFS-M,E′,A′and E′/A′between term neonates and preterm neonates(all P>0.05).Conclusion 2D-STI may be a useful method of measuring left ventricular myocardial systolic function and can provide early detection of differences in left ventricular myocardial contraction between term and preterm neonates.
作者
侯翠
徐秋琴
李晴晴
胡心璐
王辉
丁粤粤
HOU Cui;XU Qiuqin;LI Qingqing;HU Xinlu;WANG Hui;DING Yueyue(Department of Echocardiography,Soochow University Affiliated Children's Hospital,Suzhou 215025,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2023年第12期1274-1279,1281,共7页
Chinese Journal of Medical Imaging
基金
姑苏卫生人才项目(GSWS2020054,GSWS2019048)
苏州科技发展计划(SS20202066)。
关键词
二维斑点追踪成像
早产
心室功能
左
纵向峰值应变
圆周峰值应变
婴儿
新生
Two-dimensional speckle tracking imaging
Premature birth
Ventricular function,left
Longitudinal peak strain
Circumferential peak strain
Infant,newborn
