【摘要】 目的应用二维斑点追踪技术定量评价缩窄性心包炎患者术后左心室功能的改变情况。方法选取已确诊为缩窄性心包炎且择期行心包剥脱术的患者20例,行超声常规检查并存储患者心尖四腔心观、二腔心观、左室长轴观及二尖瓣环水平、乳头肌水平、心尖水平左室短轴观的足够帧频二维图像,应用二维斑点追踪技术定量分析并记录各个切面最大纵向应变、最大径向应变、最大圆周应变及各个切面的总体应变;术后1个月重复上述检查及测量。结果(1)常规超声心动图检查:缩窄性心包炎患者术后左室变大,左房及右房有不同程度缩小,左室射血分数增高,二尖瓣口舒张早期血流峰值速度增高,差异均具有统计学意义;(2)二维斑点追踪成像:缩窄性心包炎患者术后与术前比较心脏长轴方向心尖四腔心、心尖二腔心观总体纵向应变明显增高,心尖左室长轴观总体纵向应变改变不明显;二尖瓣环水平、心尖水平左室短轴观总体圆周应变明显增高,左室三个水平短轴观总体径向应变改变不明显。结论缩窄性心包炎患者心包剥脱术后左心室整体纵向应变,径向应变及圆周应变出现不同程度的升高,纵向应变升高明显,表明解除了病变心包的束缚及粘连的影响,在短时间内心室壁整体和局部收缩功能得到一定的恢复;二维斑点追踪技术可以定量评估缩窄性心包炎患者术后心脏功能的改变情况,为患者手术效果的评估提供了一个更为精确的方法。更多还原

【Abstract】 Objective To evaluate the change of cardiac function in constrictive pericarditis after pericardiectomy by two-dimensional speckle tracking Imaging.Methods 20 patients with the diagnosis of CP that decided to undergo pericardiectomy were enrolled.Echocardiography was performed before pericardiectomy to collect the imaging clips of two cavity,four cavity,long axis at apex,short axis imaging at mitral valve,papillary muscle and apex levels.The globle longitudinal strain,circumferential strain and radial strain of each imaging clip were measured by two-dimensional speckle tracking software.The globle circumferential and radial strain of short axis at different levels was defined as the average peak strain of six segments of each level.The process was repeated one month later after pericardiectomy.Results(1)Standard echocardiography:The diameter and ejection fraction of left ventricular were increased while left and right atrium were decreased at different degrees after pericardiectomy.Meanwhile,peak velocity of mitral valve during early diastole was elevated.(2) Two-dimensional speckle tracking imaging:the globle longitudinal strain of two cavity,four cavity and long axis at apex were increased at different degrees,the globle circumferential strain of short axis at mitral valve and papillary muscle levels were elevated after pericardiectomy while the radial strain of short axis at different levels have no significant change.Conclusions Two-dimensional speckle tracking imaging can quantitatively assess the cardiac change of constrictive pericarditis patients after pericardiectomy,and provided us a more accurate way to evaluate the efficiency of the operation.更多还原