二维斑点追踪技术对川崎病左心室功能评价的研究进展

Research Progress of Two-Dimensional Speckle Tracking Imaging in Evaluating Left Ventricular Function in Children with Kawasaki Disease

摘要: 常规超声心动图可以利用左心室射血分数(LVEF)、短轴缩短率(FS)等指标对左心室功能进行评估。但实际应用中上述指标只能对收缩能力进行整体评估，对于早期、局部的心肌损伤敏感性较低。川崎病(KD)是一种急性全身性血管炎，好发于五岁以下婴幼儿。由于其易损伤冠状动脉和心肌，在早期对心肌功能的评估尤为重要。随着近些年超声新技术的普及，二维斑点追踪成像技术(2D-STI)依靠其无创、精准、早期敏感等特点，可采集到心肌纵向、圆周应变等相关评估参数，对心肌进行精准、定量的评估，尽早发现早期心肌损伤。本文就该技术的应用指标、临床价值等方面进行系统阐述，为川崎病的病情评估、临床方案治疗制定以及预后评估提供理论依据。

Abstract: Conventional echocardiography assesses left ventricular function using parameters such as left ventricular ejection fraction (LVEF) and fractional shortening (FS). However, these indicators only reflect global systolic performance and exhibit low sensitivity for detecting early and focal myocardial injury. Kawasaki disease (KD) is an acute systemic vasculitis predominantly occurring in infants and children under five years old. Given its tendency to involve the coronary arteries and myocardium, early evaluation of myocardial function is of great clinical importance. With the popularization of novel ultrasonic technologies in recent years, two-dimensional speckle tracking imaging (2D-STI), characterized by non-invasiveness, accuracy and high early sensitivity, can acquire parameters including myocardial longitudinal strain and circumferential strain to realize precise quantitative evaluation of myocardium and identify early myocardial damage. This article systematically reviews the applicable parameters and clinical value of this technique, so as to provide theoretical evidence for disease monitoring, formulation of therapeutic strategies and prognostic assessment in patients with Kawasaki disease.