斑点追踪成像技术联合颈部多普勒超声评价阻塞性睡眠呼吸暂停患者右心室长轴收缩功能

Evaluation of Right Ventricular Long-Axis Systolic Function in Patients with Obstruc-tive Sleep Apnea by Speckle Tracking Imag-ing Combined with Cervical Doppler Ultra-sound

摘要: 目的：应用二维斑点追踪成像技术(2D-STI)联合颈部多普勒超声指标评价阻塞性睡眠呼吸暂停患者的右心室长轴收缩功能。资料与方法：本研究入组62例阻塞性睡眠呼吸暂停(OSA)患者，健康志愿者30例作为对照组。根据呼吸暂停–低通气指数(AHI)将OSA组分为轻度(5 ≤ AHI < 15)、中度(15 ≤ AHI < 30)、重度(AHI ≥ 30)三组；依照颈内动脉阻力指数(RI)，将OSA组分为OSA-1组(RI ≤ 0.60)、OSA-2组(RI > 0.6)。运用2D-STI测量右心室整体纵向应变(RVGLS)、右心室游离壁纵向应变(RVFWLS)，运用频谱多普勒测量颈内动脉RI。采用Pearson相关分析法分析OSA与右心室纵向应变的关系。结果：RVGLS、RVFWLS水平随OSA严重程度的增加而降低，与对照组相比有统计学差异(P < 0.01)。AHI与TAPSE、S’及RVGLS、RVFWLS均呈负相关(P < 0.01)，且AHI与RVGLS、RVFWLS的相关性更强。结论：2D-STI联合颈部多普勒指标可评价OSA患者的早期右心室长轴收缩功能改变。

Abstract: Objective: To evaluate the right ventricular long-axis systolic function in patients with obstructive sleep apnea using two-dimensional speckle tracking imaging technology (2D-STI) combined with neck Doppler ultrasound indicators. Materials and Methods: Sixty-two patients with obstructive sleep apnea (OSA) were enrolled in this study, and 30 healthy volunteers served as the control group. The OSA group was divided into three subgroups based on the apnea-hypopnea index (AHI): mild (5 ≤ AHI < 15), moderate (15 ≤ AHI < 30), and severe (AHI ≥ 30); the OSA group was further divided into OSA-1 group (RI ≤ 0.60) and OSA-2 group (RI > 0.6) according to the resistance index (RI) of the internal carotid artery. 2D-STI was used to measure the overall right ventricular longitu-dinal strain (RVGLS) and the longitudinal strain of the free wall of the right ventricle (RVFWLS), and the resistance index of the internal carotid artery was measured by spectral Doppler. Pearson cor-relation analysis was used to analyze the relationship between OSA and right ventricular longitu-dinal strain. Results: The levels of RVGLS and RVFWLS decreased with the increase in the severity of OSA, and there was a statistically significant difference compared with the control group (P < 0.01). AHI was negatively correlated with TAPSE, S’, and RVGLS, RVFWLS (P < 0.01), and the correlation between AHI and RVGLS, RVFWLS was stronger. Conclusion: The combination of 2D-STI and cervical Doppler indices can evaluate the early changes in the long-axis systolic function of the right ventri-cle in patients with OSA.