目的：通过剪切波弹性成像（SWE）技术评估慢性心力衰竭（CHF）患者腓肠肌硬度，并探讨SWE在评估CHF患者外周肌肉硬度变化中的临床价值。方法：选取临床诊断为CHF的患者30例作为心衰组，另选取同期门诊健康体检者30名作为对照组，分别对两组受检者的腓肠肌外侧头在静息和伸展状态进行SWE检查，获得杨氏模量值及剪切波速度（SWV），并进行统计分析。结果：①在腓肠肌静息状态，两组受检者的杨氏模量值与SWV没有显著的差异（P＞0.05），而当腓肠肌处于伸展状态时，对照组的杨氏模量值与SWV均明显高于心衰组，差异有统计学意义（P＜0.05）。②心衰组患者的左心室射血分数（LVEF）与腓肠肌的杨氏模量值及SWV呈显著正相关，即随着LVEF的降低，杨氏模量值及SWV逐渐减小（r=0.719，P<0.001；r=0.744，P<0.001）。结论：SWE是一种非侵入性且具有良好重复性的超声检查技术，可用于评估CHF患者的外周肌肉硬度，进而评估肌肉收缩力，使患者从早期康复锻炼计划中获益，改善肌肉收缩功能。
Abstract
Objective: To assess the gastrocnemius muscle stiffness in patients with chronic heart failure(CHF) by shear wave elastography(SWE), and to explore the clinical value of SWE in the evaluation of peripheral muscle stiffness changes in patients with CHF. Methods: Thirty patients with clinical diagnosis of CHF were selected as the heart failure group, and 30 healthy subjects from the same period were selected as the control group. SWE was performed on the lateral head of the gastrocnemius of the two groups of subjects at rest and extension, and the Young’s modulus value and shear wave velocity(SWV) were obtained, and then statistical analysis was performed. Results: ①There was no significant difference in the Young’s modulus and SWV between the two groups at the rest of the gastrocnemius(P>0.05). When the gastrocnemius muscle was in the stretching state, the Young’s modulus values and SWV of the control group were significantly higher than those of the heart failure group, the difference was statistically significant(P<0.05). ②In the heart failure group, the left ventricular ejection fraction(LVEF) was significantly positively correlated with the Young’s modulus and SWV of the gastrocnemius muscle. As the LVEF decreased, the Young’s modulus and SWV decreased gradually(r=0.719, P<0.001; r=0.744, P<0.001). Conclusion: SWE is a non-invasive and reproducible ultrasound technique that can be used to assess peripheral muscle stiffness in patients with CHF and to assess muscle contractility so that these patients benefit from early rehabilitation exercises, and then improving muscle contraction.
关键词
心力衰竭 /
充血性 /
肌 /
骨骼 /
超声检查
Key words
Heart failure, congestive /
Muscle, skeletal /
Ultrasonography
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