| Objective: Duchenne muscular dystrophy(DMD)is one of the most common and most severe types of progressive muscular dystrophy(PMD),with a incidence of about 30 per 100,000 babies,Clinical features mainly for the slow progressive increase in muscle weakness and atrophy,genetic way for the X chain implicit inheritance.Disease progression,the majority of patients with myocardial damage,such as arrhythmia,heart enlargement,heart valve insufficiency,with the above symptoms,in the absence of treatment,death is usually due to ventricular dysfunction,cardiac block Or malignant arrhythmia.Because DMD heart damage is not necessarily associated with the degree of disease skeletal muscle lesions,early may also be cardiac damage,so early detection of early intervention is particularly important.In clinical practice,echocardiography is often used to assess DMD patients with significant left ventricular dysfunction,two-dimensional spot tracking imaging techniques commonly used in early qualitative and quantitative assessment of local motion,left ventricular motion and function.In this study,we used conventional two-dimensional echocardiography and two-dimensional speckle tracking imaging to evaluate the cardiac function of children with DMD,and to explore the possibility of early diagnosis of cardiac dysfunction by two-dimensional speckle tracking imaging.At the same time,the cardiac function of children with DMD before and after treatment with prednisone was evaluated,and the use of two-dimensional spot tracking imaging technique in evaluating the evaluation of drug efficacy was explored.Methods:(1)Echocardiographic examination was performed on 19 children with DMD and 6 normal children in control group.Ultrasound dynamic images were performed using a 17-segment segmentation method using the American Society of Echocardiography using two-dimensional speckle tracking imaging to analyze myocardial contractile strain and overall myocardial contractile strain.(2)To retrospectively analyze the children with DMD in the Department of Neurology,Beijing Armed Police General Hospital from January 2016 to March 2017,and to analyze the results of echocardiography in children before and after hormone therapy.The above-mentioned ultrasonographic images were analyzed by 17-segment segmentation using the American Society of Echocardiography,and the myocardial systolic strain and total myocardium contractile strain were analyzed by two-dimensional speckle tracking imaging technique.Results:(1)The left ventricular ejection fraction of echocardiography was normal in children with DMD and normal control group,and there was no manifestation of cardiomyopathy.30 cases of children in 30 cases of echocardiography,were normal echocardiography.The LVEDD was(34.47 ± 2.69)mm,the LVEF was(63.48 ± 5.20)%,the LVESD was(21.58 ± 2.28)mm,the IVSD was(5.91 ± 0.70)mm,the LVPWD was(5.71 ± 0.34)mm,LVESV was(19.65 ± 4.24)ml and LVEDV was(51.73 ± 9.56)ml.Compared with the control group,LVEF decreased(P <0.05),while LVEDD,IVSD,LVPWD,LVESD and LVESV were increased(p <0.05).The total number of patients with DMD was 6.LVEDD was(34.47 ± 2.79)mm,LVEF was(63.48 ± 5.18)%,LVESD was(23.58 ± 2.28)mm,IVSD was(5.92 ± 0.80)mm,LVPWD was(5.78 ± 0.74(P <0.05),LVEDD,IVSD,LVPWD,LVESD and LVESV were significantly higher than those in the control group(P <0.05),and the LVEDV was(19.65 ± 4.64)ml and the LVEDV was(51.43 ± 9.56)ml(P & gt;0.05).LVEF decreased,but no significant difference(P> 0.05).(P <0.05),left ventricular free wall middle segment and apical segment(P <0.05).The left ventricular free wall of the left ventricle was significantly higher than that of the normal group(P <0.05).There was no significant difference in the middle segment,middle segment and apical segment of the interventricular septum(P <0.05).the left ventricular free wall basal segment,the middle segment,the apex of the three segments of the strain before the lower than the pre-hysteresis(P <0.05),but there was no significant difference(P> 0.05)in the interventricular septal segment strain.(P <0.05).The strain rate of the three septum was higher than that before the operation(P <0.05),but there was no significant difference between the two groups(P <0.01),but there was no significant difference between the two groups(P <0.05)Conclusion: Compared with the control group,the heart ultrasonography of patients with low age DMD mainly showed left ventricular diameter,left ventricular volume increased,left ventricular systolic function,ventricular septal and left ventricular wall thickening,but normal cardiac function.During follow-up of the DMD group,the left ventricular end diastolic diameter was reduced in the hormone group.Two-dimensional speckle ultrasound that did not use the hormone group showed a slight reduction in longitudinal strain in the apex. |
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