超声新技术评价慢性心力衰竭患者左心室功能的临床研究  

Evaluation of left ventricular function in patients with congestive heart failure with new echocardiographic techniques

作　　者：马腾[1] 王建华[1] 尹洪宁[2] 杜丽娟[2] 简文豪[1] 

机构地区：[1]北京军区总医院超声科,北京同仁医院超声科100700 [2]河北医科大学第二医院超声科

出　　处：《中华医学超声杂志（电子版）》2007年第6期338-341,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨心肌组织速度成像(TVI)和心肌应变率成像(SRI)评价心力衰竭患者左心室功能的临床价值。方法选取慢性充血性心力衰竭(CHF)患者48例,参照纽约心脏病学会(NYHA)心功能分级标准将其分为Ⅱ、Ⅲ、Ⅳ组;并选取43例健康志愿者作为正常对照组。测量传统评价心功能的参数,包括左心室射血分数(LVEF)、心脏每搏输出量(SV)、二尖瓣口舒张早期最大血流速度与舒张晚期最大血流速度比值(E/A)、E峰减速时间(DT)、等容收缩时间(ICT)、等容舒张时间(IRT)评价心肌收缩及舒张功能。同时基于组织多普勒成像技术之上测量并比较Tei指数、等容收缩期心肌收缩加速度(IVA)、收缩期峰值应变率(PSSR)和舒张早晚期峰值应变率(PESR、PASR)等参数在心力衰竭患者的改变。结果与对照组比较,CHF患者Ⅱ组和Ⅲ组的Tei指数逐渐增大,LVEF、IVA、PSSR、PESR逐渐减小(P<0.05),但Ⅲ和Ⅳ组之间差异无统计学意义;E/A、SV在Ⅲ和Ⅳ组之间差异有统计学意义(P<0.05)。PSSR和IVA与心功能分级呈负相关(r=-0.67,r=-0.80,P<0.01);Tei指数与心功能分级间呈正相关(r=0.73,P<0.01)。以Tei指数≥0.50为界值,诊断CHF的敏感性为87%,特异性为84%。结论综合评价超声新技术与传统方法的各项参数将为临床准确判断心力衰竭患者的心功能状态提供可靠依据。Objective To explore the clinical value of tissue velocity imaging(TVI) and strain rate imaging(SRI) in the assessment of left ventricular function in patients with congestive heart failure(CHF),according to NYHA classification.Methods The study population included 48 CHF patients and 43 healthy controls,and the changes of left ventricular ejection fraction(LVEF),stroke volume(SV),E/A,deceleration time(DT),isovolumic contraction time(ICT),isovolumic relaxation time(IRT),Tei index,myocardial isovolumic acceleration(IVA),peak systolic strain rate(PSSR),peak early and late diastolic strain rate(PERS and PASR) were compared.Results Compared with control group,Tei index was increased while LVEF,IVA,PSSR and PESR were decreased gradually in Ⅱ and Ⅲ groups of CHF patients but there was no difference between groups Ⅲ and Ⅳ.SV and E/A were significant different between groups Ⅲ and IV.PSSR and IVA showed a significant negative correlation while Tei index a significant positive correlation with NYHA classification(r=0.67,0.80 and 0.73 respectively,P<0.01).The sensitivity and specificity of Tei index ≥0.50 for CHF were 87.0% and 84.0% respectively.Conclusions Left ventricular function of CHF patients could be reliably evaluated by combination of parameters from new echocardiographic technique with those traditional ones.

关 键 词：彩色多普勒超声心动描记术 充血性心力衰竭 左心室功能 

分 类 号：R541.6[医药卫生—心血管疾病]