三维斑点追踪成像技术评价阻塞性睡眠呼吸暂停低通气综合征患者治疗后左心室整体收缩功能改变

目的 应用三维斑点追踪成像（3D-STI）技术评估阻塞性睡眠呼吸暂停低通气综合征（OSAHS）并发左心功能不全患者治疗后左心室整体收缩功能改变。方法 收集合并左心功能不全的重度OSAHS患者40例，随机分成试验组（n=20）和对照组（n=20），对试验组患者给予持续气道内正压通气（CPAP）治疗，对照组给予常规抗心力衰竭药物治疗；于治疗前及治疗后3个月分别行3D-STI检查，获得左心室整体纵向应变（GLS）、整体径向应变（GRS）、整体圆周应变（GCS）及整体面积应变（GAS），比较治疗前后上述指标的变化。结果 对照组治疗前后仅GLS差异有统计学意义（P=0.045），而左心室射血分数（LVEF）、GRS、GCS、GAS差异均无统计学意义（P均>0.05）；试验组治疗后LVEF、GLS、GRS、GCS、GAS均较治疗前增大（P均<0.05）；且治疗后试验组LVEF、GLS、GRS、GCS、GAS均高于治疗后对照组（P均<0.05）。结论 CPAP治疗可有效改善OSAHS患者的心功能；3D-STI技术可准确反映OSAHS患者治疗前后左心室整体收缩功能的改变。

Three-dimensional speckle tracking imaging in evaluation on changes of left ventricular systolic function in patients with obstructive sleep apnea syndrome after therapy

Objective To evaluate the changes of left ventricular overall systolic function in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) complication, left ventricular dysfunction after treatment using three-dimensional speckle tracking imaging (3D-STI). Methods Totally 40 patients with severe OSAHS and left cardiac insufficiency were enrolled, and randomly divided into experimental group (n=20) and control group (n=20). The patients in experimental group were given continuous positive airway pressure (CPAP) treatment, while the patients in control group were given routine drug for heart failure treatment. Before and 3 months after treatment, 3D-STI was performed, and parameters of the left ventricle global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS) and global area strain (GAS) were obtained and compared before and after treatment. Results In control group, only GLS showed statistically significant difference before and after treatment (P=0.045), while no statistically significant difference of left ventricular ejection fraction (LVEF), GRS, GCS nor GAS was found (all P>0.05). In experimental group, LVEF, GLS, GRS, GCS and GAS increased after treatment compared with those before treatment (all P<0.05). After treatment, LVEF, GLS, GRS, GCS and GAS in the experimental group were greater than those in the control group (all P<0.05). Conclusion CPAP treatment can effectively improve the cardiac function of OSAHS patients, and 3D-STI can accurately reflect the changes in the overall systolic function of the left ventricle before and after treatment.