摘要
目的应用相对压成像(RPI)技术可视化观察心功能正常的乙肝肝硬化患者左室内相对压差(IVPDs)、相对压力梯度(IVPGs)的变化情况,探讨RPI技术评估其左室功能的临床价值。方法选取我院临床诊断为乙肝肝硬化且心功能正常患者39例(乙肝肝硬化组)和同期健康体检者31例(对照组),应用常规超声心动图获取室间隔舒张末期厚度(IVSD)、左室后壁舒张末期厚度(LVPWD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、左房容积指数(LAVI)、二尖瓣口舒张早期和晚期血流峰值速度(E和A)、E/A、二尖瓣环室间隔处舒张早期和晚期运动峰值速度(Se’和Sa’)、二尖瓣环左室侧壁处舒张早期和晚期运动峰值速度(Le’和La’)、E与二尖瓣环间隔及侧壁处舒张早期运动峰值速度平均值的比值(平均E/e’);应用RPI技术获取左室等容收缩期、快速射血期、等容舒张期、快速充盈期、缓慢充盈期和心房收缩期IVPDs、IVPGs,比较两组上述各参数的差异;分析乙肝肝硬化组各时相IVPDs及IVPGs与常规超声心动图所测左室舒张功能参数的相关性。结果与对照组比较,乙肝肝硬化组IVSD、LVPWD、LVEDD、LAVI、A、La’、Sa’、平均E/e’、心房收缩期IVPDs、IVPGs均增高,Le’、缓慢充盈期IVPDs均减低,差异均有统计学意义(均P<0.05)。相关性分析显示,乙肝肝硬化组心房收缩期IVPDs、IVPGs与A、Sa’、La’、平均E/e’均呈正相关(均P<0.01),与E/A、Se’、Le’均呈负相关(均P<0.01),与E无相关性;缓慢充盈期IVPDs与E、A均呈负相关(均P<0.05),与Se’、Sa’、Le’、La’、E/A、平均E/e’均无相关性。结论RPI技术可定量评估心功能正常的乙肝肝硬化患者左室内IVPDs及IVPGs,为评估其左室舒张功能早期损伤提供一定参考。
Objective To analyze the changes of left ventricular intraventricular pressure differences(IVPDs)and intraventricular pressure gradients(IVPGs)in hepatitis B cirrhosis patients with normal cardiac function by relative pressure imaging(RPI)technique,and to explore its clinical value in assessing the left ventricular function.Methods Thirty-nine patients with clinical diagnosis of hepatitis B cirrhosis and normal cardiac function(hepatitis B cirrhosis group)were selected from our hospital,and 31 healthy physical examiners during the same period were selected as the control group.The interventricular septal end-diastolic thickness(IVSD),the left ventricular posterior wall end-diastolic thickness(LVPWD),left ventricular end-diastolic internal diameter(LVEDD),and left ventricular ejection fraction(LVEF),left atrial volume index(LAVI),peak early and late diastolic mitral flow velocities(E and A),E/A,peak early and late diastolic motion velocities at the septum of the mitral annulus(Se’and Sa’),peak early and late diastolic motion velocities at the left ventricular lateral wall of the mitral annulus(Le’and La’),and the ratio of E and the mean peak early diastolic motion velocities at the septum of the mitral annulus and at its lateral wall(mean E/e’)were obtained by conventional echocardiography,and IVPDs and IVPGs during left ventricular isovolumic systolic,rapid ejection,isovolumic diastolic,rapid filling,slow filling and atrial systolic phases were obtained by RPI technique.The differences of above parameters were compared between the two groups.The correlation between the IVPDs and IVPGs of each phase and conventional echocardiographic parameters in hepatitis B cirrhosis group were analyzed.Results Compared with the control group,IVSD,LVPWD,LVEDD,LAVI,A,La’,Sa’,mean E/e’,atrial systolic IVPDs and IVPGs were increased,and Le’and IVPDs during slow filling were decreased in the hepatitis B cirrhosis group,the differences were statistically significant(all P<0.05).Correlation analysis showed that durin
作者
周康
卢天祺
毕士玉
蒋健
杨秀华
张巍
ZHOU Kang;LU Tianqi;BI Shiyu;JIANG Jian;YANG Xiuhua;ZHANG Wei(Department of Abdominal Ultrasound,the First Affiliated Hospital of Harbin Medical University,Harbin 150000,China)
出处
《临床超声医学杂志》
CSCD
2023年第11期869-874,共6页
Journal of Clinical Ultrasound in Medicine
基金
黑龙江省省属高等学校基本科研业务费科研项目(2022-KYYWF-0272)。
关键词
超声心动描记术
相对压成像
乙肝肝硬化
心室功能
左
Echocardiography
Relative pressure imaging
Hepatitis B cirrhosis
Ventricula function,left
