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 pro B-type natriuretic peptide,NT-proBNP)的相关性。统计学方法采用χ^(2)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:(1259±225)mm Hg%与(1490±239)mm Hg%、(1459±233)mm Hg%;GCW:(1493±236)mm Hg%与(1687±226)mm Hg%、(1644±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。
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,and the correlation between myocardial work parameters and GLS and N-terminal pro B-type natriuretic peptide(NT-proBNP)were analyzed.Statistical methods performed byχ^(2) test,one-way ANOVA,LSD-t test and Pearson 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:(1259±225)mm Hg%vs(1490±239)mm Hg%,(1459±233)mm Hg%;GCW:(1493±236)mm Hg%vs(1687±226)mm Hg%,(1644±290)mm Hg%,all P<0.05],the GWW in dilation group was higher than that 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 the undilation group and the control group(all P>0.05),and there were no statistically significant differences in GWE among the three groups(all P>0.05).The results of Pearson correlation analysis showed t
作者
曹旭峰
牛海燕
卫炜
隋超
张宁
苏莉莉
Cao Xufeng;Niu Haiyan;Wei Wei;Sui Chao;Zhang Ning;Su Lili(Department of Ultrasound Diagnosis,the Seventh Medical Center of PLA General Hospital,Beijing 100700,China;Department of Pediatric Medicine,the Seventh Medical Center of PLA General Hospital,Beijing 100700,China;Department of Ultrasound,Tongji Shanxi Hospital,Shanxi Academy of Medical Sciences,Shanxi Bethune Hospital,Shanxi,Taiyuan 030032,China)
出处
《发育医学电子杂志》
2024年第2期108-113,共6页
Journal of Developmental Medicine (Electronic Version)
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
Pressure-strain loop
Kawasaki disease
Coronary arteries
Left ventricular systolic function
Myocardial work
