摘要
目的应用经胸超声心动图测量中原地区常驻汉族健康青年左心室乳头肌最大径,观察左心室乳头肌形态,探讨其最大径正常参考值。方法2021年1月—2023年5月河南省人民医院体检健康汉族青年1194例,均行经胸超声心动图检查,于胸骨旁左心室乳头肌水平短轴切面观察乳头肌形态。选择左心室单头状乳头肌青年,于舒张末期测量左心室前外侧乳头肌(APM)、后内侧乳头肌(PPM)中段前后径、左右径,以APM或PPM前后径或左右径的最大值为左心室乳头肌最大径,采用95%医学参考值范围公式计算男、女性左心室乳头肌最大径参考值范围;采用Pearson相关法分析左心室乳头肌最大径与体质量指数(BMI)的相关性。选择同期30例健康体检者,由2名经验丰富的超声科医师行经胸超声心动图检查,测量并计算左心室乳头肌最大径,间隔1 h进行重复测量,采用组内相关系数(ICC)分析观察者间及观察者内测量的一致性。结果(1)1194例中左心室乳头肌形态为单头状者1106例。1106例单头状者中,男545例,BMI为(21.31±1.67)kg/m^(2);女561例,BMI为(21.39±1.44)kg/m^(2)。男性左心室APM横断面呈椭圆形366例(67.16%)、圆形179例(32.84%),PPM横断面呈椭圆形386例(70.83%)、圆形159例(29.17%)。女性左心室APM横断面呈椭圆形386例(68.81%)、圆形175例(31.19%),PPM横断面呈椭圆形417例(74.34%)、圆形144例(25.66%)。(2)男性青年左心室APM前后径、左右径[(8.25±1.10)、(8.29±1.13)mm]与PPM前后径、左右径[(8.29±1.03)、(8.28±1.08)mm]比较差异均无统计学意义(t=-0.538,P=0.591;t=0.231,P=0.817)。女性青年左心室APM前后径、左右径[(7.43±1.01)、(7.46±1.06)mm]与PPM前后径、左右径[(7.47±1.07)、(7.43±1.06)mm]比较差异均无统计学意义(t=-0.685,P=0.494;t=0.395,P=0.693)。(3)男性青年左心室乳头肌最大径为(9.11±1.14)mm,女性青年为(8.10±1.01)mm。男性青年左心室乳头肌最大径参考值为6.87~11.34 mm,女性青年为6.12~10.07 mm。(4)男、女性青年左心室乳头肌最大径与BMI均无相关性(r=0.065,P=0.128;r=0.010,P=0.795)。(5)左心室APM、PPM前后径及左右径在观察者间、观察者内测量的一致性均较好(ICC均>0.75)。结论中原地区1194例汉族健康青年左心室乳头肌形态以单头状、椭圆形多见,男、女性青年左心室单头状乳头肌最大径与BMI无关,男性青年左心室乳头肌最大径参考值为6.87~11.34 mm,女性青年为6.12~10.07 mm。
Objective To measure the maximum diameter(Md)of the left ventricular papillary muscle in the healthy young residents of Han nationality in Central China by using transthoracic echocardiography,to observe the morphology of the left ventricular papillary muscle,and to explore the normal value of the Md.Methods From January 2021 to May2023,1194 healthy young residents of Han nationality received health examination in Henan Provincial People's Hospital.All of them received transthoracic echocardiography to observe the morphology of papillary muscle in the shortaxis view at the level of left ventricular papillary muscle beside the sternum.The anteroposterior and left-right diameters of single anterolateral papillary muscle(APM)and single posteromedial papillary muscle(PPM)of the left ventricle were measured at the end of diastole in young residents.Taking the maximum anteroposterior and left-right diameters of APM or PPM as the Md of left ventricular papillary muscle,the reference range of Md of left ventricular papillary muscle in males and females was calculated by 95% medical reference range formula.Pearson correlation method was used to analyze the correlation between Md and body mass index(BMI).Another 30 healthy volunteers during the same period were selected and performed transthoracic echocardiography by two experienced sonographers to measure and calculate Md.Transthoracic echocardiography was repeated every other hour to analyze the consistency by intra-class correlation coefficient(ICC)within and between groups.Results(1)In 1194 subjects,the left ventricular papillary muscle was single in 1106,among whom 545 were males with BMI of(21.31±1.67)kg/m^(2),and 561 were females with BMI of(21.39±1.44)kg/m^(2).In males,the papillary muscle cross-section of APM showed oval shape in 366 subjects(67.16%)and circular shape in 179(32.84%),and PPM showed oval shape in 386 subjects(70.83%)and circular shape in 159(29.17%).In females,the papillary muscle cross-section of APM showed oval shape in 386 subject(68.81%)and circular shape in 175(31.19%),and PPM showed oval shape in 417 subject(74.34%)and circular shape in 144(25.66%).(2)In males,the anteroposterior diameter and left-right diameter of APM were not significantly different from those of PPM[(8.25±1.10)mm vs.(8.29±1.03)mm;(8.29±1.13)mm vs.(8.28±1.08)mm](t=-0.538,P=0.591;t=0.231,P=0.817).In females,the anteroposterior diameter and left-right diameter of APM were not significantly different from those of PPM[(7.43±1.01)mm vs.(7.47±1.07)mm;(7.46±1.06)mm vs.(7.43±1.06)mm](t=-0.685,P=0.494;t=0.395,P=0.693).(3)The Md of the left ventricular papillary muscle was(9.11±1.14)mm in males and(8.10±1.01)mm in females.The reference Md ranged from 6.87 to 11.34 mm for males and from 6.12 to 10.07 mm for females.(4)The Md of the left ventricular papillary muscle was not correlated with the BMI in males and females(r=0.065,P=0.128;r=0.010,P=0.795).(5)The anteroposterior and left-right diameters of the ventricular papillary APM and PPM were in good consistency within and between groups(ICC>0.75).Conclusions The left ventricular single papillary muscle in oval shape is more common in these 1194young subjects of Han nationality.The Md of left ventricular single papillary muscle is not correlated with BMI in males and females.The reference Md of left ventricular papillary muscle ranges from 6.87 to 11.34 mm for males and from 6.12to 10.07 mm for females.
作者
汪喜瑞
朱好辉
张喜君
张辉辉
袁建军
WANG Xirui;ZHU Haohui;ZHANG Xijun;ZHANG Huihui;YUAN Jianjun(Department of Ultrasound,Zhengzhou University People's Hospital,Henan Provincial People's Hospital,Zhengzhou,Henan 450003,China)
出处
《中华实用诊断与治疗杂志》
2023年第9期948-952,共5页
Journal of Chinese Practical Diagnosis and Therapy
基金
河南省医学科技攻关计划省部共建重点项目(SBGJ202102013)。
关键词
左心室乳头肌
经胸超声心动图
最大径正常参考值
汉族
健康青年
left ventricular papillary muscle
transthoracic echocardiography
normal reference value of maximum diameter
Han nationality
healthy youth
作者简介
通信作者:袁建军,E-mail:yuan2373@163.com。
