作　　者： ; ;

机构地区： 自贡市第四人民医院

出　　处： 《西部医学》 2018年第7期1046-1050,1059,共6页

摘　　要： 目的二维斑点追踪(2D-STI)技术评估手足口病(HFMD)患儿左室心肌各节段收缩功能。方法选取经临床确诊及病原学证实均为EV71型病毒感染的HFMD患儿41例,分为轻症组和重症组,对照组为体检健康儿童21例。对每位儿童测量LVEF(Simpson法)和Tei指数,运用2D-STI技术获得左心室各节段室壁应变峰值牛眼图及整体纵向应变(GLS),并采取同期多项生化指标进行对比分析。结果 HFMD重症组患儿白细胞总数(WBC)、心率、血糖(GLU)、CRP、CK、CK-MB均明显高于轻症组和对照组(P<0.05)。HFMD重症组LVEF、GLS相对于轻症组和对照组明显减低,Tei指数明显高于轻症组和对照组,差异均有统计学意义(P<0.01)。重症组左室后、侧、下壁基底段,后、侧壁及后室间隔中间段,后室间隔、侧壁心尖段,心尖部应变峰值相对于对照组均减低(P<0.05);重症组左室后壁基底段,后室间隔、侧壁心尖段,后、侧壁及后室间隔中间段,心尖部应变峰值均低于轻症组(P<0.05);轻症组仅见于左室后、侧壁基底段,后、侧壁中间段,侧壁心尖段应变峰值相对于对照组均减低(P<0.05)。结论 HFMD患儿存在不同程度左室局部或整体心肌收缩功能改变。2D-STI技术可发现即使常规超声心动图显示正常患儿的心脏功能细微变化,牛眼图中数值及颜色变化可直观地了解病变心肌节段和程度,为临床早期诊治提供帮助。 Objective The present study evaluated the left ventricular systolic function using two-dimensional speckle tracking imaging（2 D-STI）in patients with Hand-foot-mouth disease（HFMD）.Methods 41 children hospitalized with HFMD caused by EV71 were recruited in the experimental group,which were further separated into mild and severe groups based on the severity.21 healthy subjects were used as control.LVEF（Simpson）and Tei index was acquired.Then,using 2 D-STI for calculation of global longitudinal strain（GLS）.The clinical characteristics and echocardiographic findings were compared.Results An increase of WBC count,heart rate,blood glucose,CRP,CK,and CKMB levels was detected in severe HFMD group（P〈0.05）compared to mild HFMD and control groups.There was no different of clinical features between mild HFMD and control groups.Severe HFMD patients experienced lower LVEF and GLS,and higher Tei index compared to mild HFMD and control groups（P〈0.01）.Mild HFMD group,on the other hand,had comparable LVEF,Tei index,and GLS as the control group.The severe HFMD group had lower LPSS on LV inferior,lateral,epical,and mid-and basal-inferoseptal segments compared to control group.Compared to the mild HFMD group,the severe HFMD group was detected lower LPSS on basal-and mid-inferior,mid-and epical-lateral,midand epical inferoseptal,and epical segments.And the mild HFMD group exhibited lower LPSS on lateral and basal-and mid-inferior segments compared to the control group.Conclusion HFMD patients experienced segmental and global cardiac systolic dysfunction.2 DSTI has high sensitivity to detect the changes of cardiac function,provide information for early diagnosis and cure.

关 键 词： 手足口病 心功能 二维斑点追踪技术 应变

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