目的：探讨应用超声二维斑点追踪技术（2D-STI）定量评价不同程度室间隔缺损（ VSD）患者左房功能的价值。方法将 VSD 患儿53例根据VSD大小与主动脉根部比值分为大室缺（ VSDL ）组13例、中等室缺（ VSDM ）组19例、小室缺（ VSDS ）组21例；另取性别、年龄与VSD患者匹配的健康儿童35例作为对照组。计算各组肺循环血流量／体循环血流量比值（QP／Qs）；二维超声检测各组左房收缩期前后径（LADs）、最大容积（LAVmax）、最小容积（LAVmin），并计算左房射血分数及左房容积指数（LAVI）；2D-STI测量各组左房收缩期峰值纵向应变（LS）、应变率（LSR-s）、舒张早期峰值纵向应变率（LSR-e）、舒张晚期峰值纵向应变率（LSR-a）。结果 QP／Qs 随VSD缺损程度的增大而增大（P均＜0．05）；VSDL 组LADs较其他各组增大（P均＜0．05）；VSDM组、VSDL组容积参数（LAVmax、LAVmin、LAVI）较其他两组增大（P均＜0．05），且VSDL组较VSDM组增大（P均＜0．05）；VSDM 组、VSDL组应变参数（LS、LSR-s、LSR-e）较其他两组减低（P均＜0．05），VSDL组减低更明显（P均＜0．05）；VSDM组、VSDL组LSR-a较其他两组增大（P均＜0．05），且两组间差异有统计学意义（P＜0．05）。结论中、重度的VSD患者左房储存功能、管道功能减低，泵功能增强；2D-STI技术对评价VSD患儿左房功能具有重要价值。%Objective To invesitgate the value of using two-dimensional speckle tracking imaging (2D-STI) in quantita-tive assessment of left atrial (LA) function of children with different shunting of ventricular septal defect (VSD).Methods To-tally 53 patients with VSD were divided into three groups:the large group (VSDL group, 13 cases), the moderate group (VSDM group, 19 cases) and the small group (VSDS group, 21 cases).In addition, 35 healthy subjects were selected as the control group.Then QP/Qs was calculated;the parameters of LA diameter (LADs), maximum volum (LAVmax), minimum volume (LAVmin), left atrial ejection fraction and volume index (LAVI) and LA longitudinal systolic strain (LS), longitudinal systolic strain rate ( LSR-s), longitudinal early diastole strain rate (LSR-e) and longitudinal late diastole strain rate (LSR-a) in each group were measured to assess the LA functions by 2D-SIT.Results The QP/Qs was increased with the increasing defect size of patients (all P<0.05).The LADs in the VSDL group was the larger than that of the other groups (all P<0.05).The LAVmax, LAVmin and LAVI in the VSDM and VSDL groups were larger than those of the control and VSDs groups (all P<0.05), and the VSDL group was lager than the VSDM group (all P<0.05).The LS, LSR-s and LSR-e in the VSDM and VSDL groups were de-creased as compared with those of the other groups (all P<0.05), and the VSDL group was more significant (all P<0.05).The LSR-a in the VSDM and VSDL groups were higher than that of the control and VSDs groups (all P<0.05) and there were signifi-cant differences between the VSDM and VSDL groups (P<0.05).Conclusion For patients with moderate or severe VSD, the storage and piping functions of left atrium are decreased, but the pump function is enhanced;and 2D-STI has important value in assessment of left atrial function in children with VSD.
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