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发育医学电子杂志  2024, Vol. 12 Issue (2): 108-113    DOI: 10.3969/j.issn.2095-5340.2024.02.005
  结构畸形   论著 |
左心室压力- 应变环评估川崎病患儿左心室收缩功能的定量研究
曹旭峰 牛海燕 卫炜 隋超 张宁 苏莉莉
(1. 解放军总医院第七医学中心 超声诊断科,北京 100700;2. 解放军总医院第七医学中心 儿内科,北京100700;3. 山西白求恩医院 山西医学科学院同济山西医院 超声科,山西 太原 030032)
Quantitative evaluation of left ventricular systolic function in children with Kawasaki disease by left ventricular pressure-strain loop
Cao Xufeng, Niu Haiyan, Wei Wei, et al
(1. Department of UltrasoundDiagnosis, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China; 2. Departmentof Pediatric Medicine, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China;3.Department of Ultrasound, Tongji Shanxi Hospital, Shanxi Academy of Medical Sciences, Shanxi Bethune Hospital, Shanxi,Taiyuan 030032, China)
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摘要 【摘要】 目的  应用无创左心室压力- 应变环(left ventricular press-strain loop,LVPSL)评估不同病变程
度川崎病(Kawasaki disease,KD)患儿左心室收缩功能。 方法 将2020 年9 月至2022 年12 月于解放
军总医院第七医学中心住院的55 例KD 患儿纳入研究,根据冠状动脉有无扩张分为扩张组(n=21)和未
扩张组(n=34),另选取同期与KD 患儿年龄、性别相匹配的健康儿童28 例作为对照组。采集KD 患儿
及健康儿童的一般资料,并进行超声心动图检查,计算左心室整体纵向应变(global longitudinal strain,
GLS)、整体做功指数(global work index,GWI)、整体有效功(global constructive work,GCW)、整体无效功(global wasted work,GWW)及整体做功效率(global work efficiency,GWE)。对3 组间左心室常规超声心动图及心肌做功参数进行比较,并分析心肌做功参数与GLS、N 末端B 型脑钠肽(N-terminal proB-type natriuretic peptide,NT-proBNP)的相关性。统计学方法采用χ2 检验、单因素方差分析、LSD-t 检验、Pearson 相关性分析。 结果  3 组常规超声心动图参数比较,差异均无统计学意义(P 值均>0.05)。扩张组GLS、GWI、GCW 低于对照组和未扩张组[GLS :(-19.5±2.9)% 与(-21.6±2.1)%、(-21.4±2.4)% ;GWI:( 1 259±225)mm Hg%与(1 490±239)mm Hg%、(1 459±233)mm Hg%;GCW:( 1 493±236)mm Hg%与(1 687±226)mm Hg%、(1 644±290) mm Hg%,P 值均<0.05],扩张组GWW 高于对照组和未扩张组[(66±29)mm Hg% 与(49±23)mm Hg%、(53±20)mm Hg%,P 值均<0.05]。未扩张组和对照组GLS、GWI、GCW、GWW 比较,差异均无统计学意义(P 值均>0.05),3 组间GWE 比较差异均无统计学意义(P 值均 >0.05)。Pearson 相关性分析结果显示,GLS 与 GWI、GCW 呈负相关( r=-0.717,P<0.001;r=-0.791,P<0.001)。 GWI、GCW与 NT-proBNP 呈负相关( r=-0.749,P<0.001 ;r=-0.702,P<0.001)。结论 无创LVPSL 能够定量评估不同病变程度KD 患儿左心室心肌做功的变化,早期、敏感地反映KD患儿左心室收缩功能损害情况。
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关键词:  压力- 应变环  川崎病  冠状动脉  左心室收缩功能  心肌做功    
Abstract: 【Abstract】 Objective To evaluate left ventricular systolic function in children with Kawasaki disease
(KD) with different degrees of lesion by non-invasive left ventricular pressure-strain loop (LVPSL)
Method A total of 55 pediatric patients with KD admitted to the Seventh Medical Center of PLA General
Hospital from September 2020 to December 2022 were included in the study. KD patients were divided
into dilation group (n=21) and undilation group (n=34) based on the presence or absence of coronary artery dilation. Twenty-eight healthy children matching the age and gender of the KD group in the same period were selected as the control group. KD patients and healthy children underwent echocardiography. The left ventricle global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW),global wasted work (GWW), and global work efficiency (GWE) were calculated. The left ventricular
conventional echocardiography and myocardial work parameters among the three groups were compared, andthe correlation between myocardial work parameters and GLS and N-terminal pro B-type natriuretic peptide(NT-proBNP) were analyzed. Statistical methods performed by χ2 test, one-way ANOVA, LSD-t test andPearson correlation analysis. Result There was no significant differences in conventional echocardiography parameters among the three groups (all P>0.05). The GLS, GWI and GCW in dilation group were lower than those in control group and undilation group [GLS: (-19.5±2.9) % vs (-21.6±2.1) %, (-21.4±2.4) %; GWI:(1 259±225) mm Hg%vs (1 490±239) mm Hg%, (1 459±233) mm Hg%; GCW: (1 493±236) mm Hg% vs(1 687±226) mm Hg%, (1 644±290) mm Hg%, all P<0.05], the GWW in dilation group was higher thanthat in control group and the undilation group [(66±29) mm Hg% vs (49±23) mm Hg%, (53±20) mm Hg%,all P<0.05]. There were no statistically significant differences in GLS, GWI, GCW and GWW among theundilation group and the control group (all P>0.05), and there were no statistically significant differencesin GWE among the three groups (all P>0.05). The results of Pearson correlation analysis showed that, theGLS was negatively correlated with GWI and GCW (r=-0.717, P<0.001; r=-0.791, P<0.001). The GWI andGCW were negatively correlated with NT-proBNP (r=-0.749, P<0.001; r=-0.702, P<0.001). Conclusion Noninvasive LVPSL can quantitatively evaluate the changes in left ventricular myocardial work of KD children with different degrees of lesion, and it can early and sensitively reflect left ventricular systolic function damage
Key words:  Pressure-strain loop    Kawasaki disease    Coronary arteries    Left ventricular systolic function    Myocardial work
收稿日期:  2023-09-01                     发布日期:  2024-03-29     
通讯作者:  苏莉莉    E-mail:  1024257053@qq.com
引用本文:    
曹旭峰 牛海燕 卫炜 隋超 张宁 苏莉莉. 左心室压力- 应变环评估川崎病患儿左心室收缩功能的定量研究[J]. 发育医学电子杂志, 2024, 12(2): 108-113.
Cao Xufeng, Niu Haiyan, Wei Wei, et al. Quantitative evaluation of left ventricular systolic function in children with Kawasaki disease by left ventricular pressure-strain loop. Journal of Developmental Medicine(Electronic Version), 2024, 12(2): 108-113.
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