Page 47 - 南京医科大学学报自然科学版

第44卷第2期 南京医科大学学报（自然科学版）
2024年2月 Journal of Nanjing Medical University（Natural Sciences） ·185 ·

·临床研究·

运用二维斑点追踪技术评估长新冠综合征患者早期亚临床心

肌损害的研究

赵 迪，张艳娟，王连生，刘加宝 *

南京医科大学第一附属医院心血管内科，江苏 南京 210029

［摘 要］ 目的：应用二维斑点追踪技术评价长新冠综合征患者早期亚临床心肌损害的应用价值。方法：在南京医科大学第一附
属医院门诊连续入组2022年12月7日我国放开疫情管控后新冠感染患者59例作为观察组，选取新冠流行前门诊者60例作为
健康对照组，收集患者基本临床资料及心肌损伤标志物等化验指标，采用二维心超及二维斑点追踪技术（two⁃dimensional
speckle tracking imaging，2D⁃STI）评估患者左室射血分数（left ventricular ejection fraction，LVEF）、左室舒张功能E/A、E/e’，左心
室整体纵向应变（global longitudinal strain，GLS）及十八节段应变值，计算并比较各组间心率、LVEF、E/A、E/e’、GLS及十八节段
应变值。结果：研究发现长新冠综合征患者的左室舒张功能 E/A（1.14±0.34 vs. 1.46±0.44，P<0.001）、E/e’（8.01±2.08 vs. 7.21±
1.53，P<0.05）及左室GLS［（-20.57±2.15）% vs.（-21.90±1.73）%，P<0.001］较健康对照组显著下降。进一步行十八节段应变分
析发现新冠组患者主要表现为前间隔基底部、前壁中间部、前间隔中间部、下侧壁中间部、前侧壁中间部、前壁心尖部、前间隔
心尖部、下壁心尖部、下侧壁心尖部和前侧壁心尖部等十个节段的显著降低（P<0.05）。通过感染后时间的亚组分析发现，随着
新冠康复时间延长，患者GLS呈现逐渐改善趋势。结论：新冠后患者常出现左室舒张功能及GLS的下降。而随着新冠康复时
间的延长，上述指标呈现逐渐改善趋势。应用2D⁃STI可以定量评估长新冠综合征患者早期亚临床心肌损害，可能为新冠患者
的临床诊治提供一定依据。
［关键词］ 新冠感染；长新冠综合征；二维斑点追踪技术；左室整体纵向应变；心脏功能

［中图分类号］ R540.45 ［文献标志码］ A ［文章编号］ 1007⁃4368（2024）02⁃185⁃06
doi：10.7655/NYDXBNSN230724

Study on the evaluation of early subclinical myocardial damage in patients after long
COVID syndrome by two⁃dimensional speckle tracking imaging

*
ZHAO Di，ZHANG Yanjuan，WANG Liansheng，LIU Jiabao
Department of Cardiology，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［Abstract］ Objective：To evaluate the application value of early subclinical myocardial damage in patients with long COVID using
two⁃dimensional speckle tracking imaging（2D⁃STI）technology. Methods：Fifty⁃nine patients with post⁃COVID infection after the
unsealing of the COVID epidemic in China on December 7，2022 were enrolled as the observation group，and 60 pre⁃epidemic healthy
people who were screened in the out patient department were selected as the healthy control group. Basic clinical data，markers of
myocardial injury and other laboratory indicators of patients were collected. Two⁃dimensional echocardiography and 2D⁃STI were used
to evaluate left ventricular ejection fraction（LVEF），left ventricular diastolic function（E/A，E/e’），global longitudinal strain（GLS），
and segmental strain values，and the heart rate，LVEF，E/A，E/e’，GLS，and segmental strain values were calculated and compared
between the groups. Results：The study found that the left ventricular diastolic function E/A（1.14±0.34 vs. 1.46±0.44，P<0.001），E/e’
（8.01±2.08 vs. 7.21±1.53，P<0.05），and GLS［（-20.57±2.15）% vs.（-21.90±1.73）%，P<0.001］of patients with long COVID syndrome
were significantly decreased compared to healthy control individuals. Further segmental strain analysis revealed significant decreases
in ten segments，including basal anteroseptal，mid anterior，mid anteroseptal，mid inferolateral，mid anterolateral，apical anterior，apical
anteroseptal，apical inferior，apical inferolateral and apical anterolateral in the COVID group（P<0.05）. Subgroup analysis based on post

［基金项目］ 国家自然科学基金（81901416）；江苏省自然科学基金（BK20191067）
∗
通信作者（Corresponding author），E⁃mail：jiabaoliu@njmu.edu.cn