【作者】 孙燕；

【导师】 游向东；

【作者基本信息】 浙江大学 ， 影像医学与核医学， 2018， 硕士

【摘要】 目的:通过速度向量成像技术VVI的应用研究吸毒者左心室心肌各个方向上的收缩功能的改变特点。方法:对143例吸毒者和58例健康对照者行常规超声心动图(UCG)和左心室整体应变检查和测量,并将吸毒者按照年限分为A(吸毒1～3年)、B(吸毒3-6年)、C(吸毒大于6年)三组,先超声心动图做常规测量比较各组间年龄、性别、常规超声心动图参数;在启用VVI模式,测量左心室整体纵向、径向和环向峰值应变,比较各组间的差异,并评估IVST、LVPWT、LVEF、左心室整体纵向、径向和环向峰值应变与吸毒年限间的关系。结果:与对照组、A组和B组比较,实验组C组表现为明显上升的指标有IVST、LVPWT、LVIDd三项,明显下降的指标有LVEF,上述四项指标的差异均表现为具有统计学意义,通过对A组和B组进行比较,可以发现对照组之间的4项指标差异均表现为未见统计学意义。左心室整体径向峰值应变表现为实验组C组差异具有统计学意义,对照组差异不具有统计学意义,左心室整体纵向峰值应变不管是在实验组C组还是在对照组A、B组之间的差异项都表现为具有统计学意义,左心室整体径向峰值应变在对照组、A组和B组间差异均无统计学意义;左心室整体环向峰值应变在C组与其他组间差异均有统计学意义,左心室整体环向峰值应变在对照组、A组和B组间差异均无统计学意义。纵向和环向峰值应变在统计学上表现为与与吸毒年限均有一定程度的相关性,与吸毒年限的相关性最好的是纵向峰值应变。结论:1.毒品对人的左心室重建和心肌收缩功能会产生毒性作用。2.毒品对左心室心肌毒性在早期临床特征不明显但仍然可以检测到左室心肌纵向收缩功能的损伤。3.随着吸毒年限的增加,毒品对心肌的损伤逐渐扩散到心内膜中层和上层,进一步损伤心肌径向和环向收缩功能。吸毒者心脏功能的损伤程度与吸毒年限有关,毒龄越短,损伤越小。4.心肌受损早期的症状主要表现为纵行心肌受损引起的左室纵向收缩异常,但是中层和上层心肌未受影响,因而环向和径向收缩正常,直到后期产生全面心肌损伤才会表现出异常。5.速度向量成像技术能够灵敏地反映出左室心肌纵向收缩功能的改变,这可以作为吸毒早期心肌损伤的信号灯。更多还原

【Abstract】 Objective:To evaluate the characteristics of left ventricular longitudinal,circumferential and radial systolic function changes in drug addicts by velocity vector imaging.Methods:Conventional echocardiography and left ventricular global strain were examined and measured in 143 drug addicts and 58 healthy controls,and the drug addicts are divided into three groups according to the years of drug taking:A group(drug taking 1-3 years),B group(drug taking 3～6 years)and C group(drug taking is more than 6 years).The differences in age,sex,conventional echocardiographic parameters,and left ventricular global longitudinal,radial,and circumferential peak strain were compared,and the relationship between IVST,LVPWT,LVEF,left ventricular overall longitudinal,radial,and circumferential peak strains,and the years of drug taking were evaluated.Results:Compared with the control group,the A group and the B group,the IVST and LVPWT in the C group were significantly thickened,LVIDd significantly increased,and LVEF significantly decreased,the difference was statistically significant,and there was no significant difference in IVST,LVPWT,LVIDd and LVEF between the control group,the A group and the B group.The global longitudinal peak strain of left ventricular in each group was statistically significant.The left ventricular global radial peak strain was statistically significant between the C group and the other groups,and the left ventricular global radial peak strain was not statistically significant in the control group,between the A group and the B group.The left ventricular global circumferential peak strain was statistically significant between the C group and the other groups,and the left ventricular global circumferential peak strain was not statistically significant in the control group,between the A group and the B group.The global longitudinal peak strain and circumferential peak strain of the left ventricle were significantly related to the years of drug taking,and the global longitudinal peak strain of the left ventricle correlates best with the years of drug taking.Conclusion:The global longitudinal systolic function of the left ventricle is an effective parameter to reflect the myocardial dysfunction of the left ventricle caused by drug abuse.更多还原