三维斑点追踪技术定量评价动脉导管未闭合并肺动脉高压患者左心室整体应变

目的 探讨三维斑点追踪技术（3D-STI）定量评价动脉导管未闭（PDA）患者左心室整体收缩功能的价值。方法 随机选取常规超声心动图确诊为PDA的患者51例（病例组），其中单纯PDA35例（单纯PDA亚组），合并肺动脉高压（PAH）16例（合并PAH亚组）；另选取性别、年龄相匹配的健康体检者35名（对照组）。所有研究对象分别接受常规超声心动图检查及3D-STI检查，获取左心室舒张末期内径（LVDD）、左心室收缩末期内径（LVDS）、左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）、左心室射血分数（LVEF）、左心室整体纵向应变（GPLS）、整体圆周应变（GPCS）、整体径向应变（GPRS）以及整体面积应变（GPAS）等指标，并行统计分析。结果 单纯PDA亚组的PAD、LVDD、LVDS、LVEDV、LVESV、GPLS、GPCS、GPRS和GPAS均高于对照组（P均 < 0.05）。合并PAH亚组的PAD、LVDD、LVDS、LVEDV均高于对照组，GPAS低于对照组（P均 < 0.05）。3组LVEF差异无统计学意义（P > 0.05）。单纯PDA亚组的PAP、PD、PAD明显低于合并PAH亚组，而GPLS、GPCS、GPRS和GPAS高于合并PAH亚组（P均<0.05）。结论 3D-STI检查可有效评价PDA患者LVEF正常时左心室整体应变变化，且单纯PDA患者左心室整体应变明显增强，合并有PAH时整体应变下降。

Three-dimensional speckle tracking technique in quantitative evaluation on global left ventricular strain in patients with patent ductus arteriosus and pulmonary hypertension

Objective To investigate the value of three-dimensional speckle tracking imaging in quantitative evaluation of left ventricular global systolic function in patients with patent ductus arteriosus. Methods Totally 51 cases of PDA (case group)confirmed by conventional echocardiography were analyzed. Among them, 35 cases (simple PDA subgroup) were, simple PDA 16 cases (PAH subgroup) were combined with PAH. Another 35 volunteers (control group)of sex and age matched were selected. All subjects received routine echocardiography and 3D-STI examination. LVDD, LVDS, LVEDV, LVESV, LVEF and GPLS, GPCS, GPRS, GPAS and other indicators were obtained. The differences of all above parameters between the two groups were compared. Results PAD, LVDD, LVDS, LVEDV, LVESV, GPLS, GPCS, GPRS and GPAS in simple PDA subgroup were all higher than those in control group (all P<0.05). PAD, LVDD, LVDS and LVEDV in PAH subgroup were higher than those in control group, while GPAS was lower than that in control group (all P<0.05). There was no significant difference of LVEF in three groups (P>0.05). PAP, PD and PAD in simple PDA subgroup were lower than those in PAH subgroup, while GPLS, GPCS, GPRS and GPAS were higher than those in PAH subgroup (all P <0.05). Conclusion 3D-STI examination can effectively evaluate the left ventricular global strain changes in PDA patients with normal LVEF, and the global strain of left ventricle in patients with simple PDA is significantly enhanced, but decreased when PDA combined with PAH.