应用超声心动图及核素和X射线心室造影评估冠心病患者左心室收缩和舒张功能的相关性  

Evaluation on the correlation between the systolic and diastolic functions of left ventricle in patients with coronary heart disease by using ultrasonic cardiogram, nuclide and X ray

作　　者：刘泽[1] 冯德光[1] 王鲁妮[1] 戴波[1] 黄纪昌[1] 王伟[1] 

机构地区：[1]解放军广州军区广州总医院干部内五科,广东省广州市510010

出　　处：《中国临床康复》2005年第3期54-55,共2页Chinese Journal of Clinical Rehabilitation

基　　金：广东省科研重点项目基金资助(粤科计字1997-7705)~~

摘　　要：目的:探讨有创与无创检查方法对冠心病左心室收缩、舒张功能障碍的诊断价值及其相关关系。方法:测定并比较64例冠心病患者不同临床纽约心脏协会(NewYorkHeartAssociation,NYHA)分级时的射血分数、E峰、A峰、E/A和射血分数斜率以及高峰射血率(peakejectiverate,PER)和高峰充盈率(peakfillingrate,PFR)值,并进行相关分析。结果:心功能Ⅲ级组的射血分数值低于心功能Ⅰ,Ⅱ级组,Ⅱ或Ⅲ级组超声射血分数分别为0.719±0.066和0.580±0.093,高于同组其他方法测的射血分数值(P均<0.05);Ⅰ,Ⅱ,Ⅲ级组间的PER分别为(3.015±0.330),(2.535±0.370)和(1.937±0.282)EDV/s,差异有显著性意义(P均<0.01);Ⅲ级组E峰为(0.781±0.151)m/s,射血分数斜率为(68.17±18.09)mm/s,分别低于Ⅰ级组犤(0.931±0.200),(90.05±27.27)mm/s犦(P均<0.05);超声射血分数与核素射血分数、超声射血分数与X线造影射血分数、核素射血分数与X线造影射血分数之间呈正相关(r=0.544,0.525,0.850,P<0.01),NYHA分级与年龄呈正相关(r=0.329,P<0.05),与E峰、E/A、射血分数斜率以及PFR也呈负相关(r=-0.312,-0.270,-0.358,-0.290,P<0.05);年龄与E峰、E/A、射血分数斜率以及PFR均呈负相关(r=-0.648,-0.776,-0.748,-0.608,P<0.01);PFR与E峰、E/A、射血分数?AIM:To study the diagnostic value and correlation between traumatic and non-traumatic examining methods for systolic or diastolic dysfunction of left ventricle in coronary heart disease(CHD). METHODS:The ejection fraction(EF),E peak, A peak,E/A ratio, EF slope rate,peak ejective rate(PER) and peak filling rate(PFR) of 64 CHD patients were examined and compared when graded according to the different degrees of New York Heart Association(NYHA),and their correlations were analyzed. RESULTS:The EF value of heart function were lower in the grade Ⅲgroup than in the grade Ⅰand Ⅱgroups.The ultrasonic EF value in the grade Ⅱand Ⅲgroups(0.719±0.066, 0.580±0.093) were higher than those measured with other methods in the same group(P< 0.05).The PER between the grade Ⅰ,Ⅱand Ⅲgroups were significantly different[(3.015 ±0.330), (2.535±0.370), (1.937±0.282) EDV/s](P< 0.01).E peak and EF slope rate in the grade Ⅲgroup[(0.781±0.151) m/s,(68.17±18.09) mm/s]were lower than those in the grade Ⅰgroup[(0.931±0.200) m/s,(90.05±27.27) mm/s](P< 0.05).There were positive correlations between the ultrasonic EF values and the nuclide ones,ultrasonic and the X ray ones,nuclide and X ray ones respectively(r =0.544,0.525,0.850,P< 0.01).NYHA grade was positively correlated with age(r=0.329, P< 0.05),while had negative correlation with E peak, E/A, EF slope rate and PFR(r=-0.312,-0.270,-0.358, -0.290,P< 0.05),and age was also negatively correlated with E peak,E/A,EF slope rate and PFR(r=-0.648,-0.776,-0.748,-0.608,P< 0.01).PFR had positive correlation with E peak,E/A and EF slope rate(r=0.549,0.590,0.629,P< 0.05). CONCLUSION:There is certain correlation between the systolic or diastolic indexes in the CHD patients respectively.PER is the most propitious for the diagnosis of systolic dysfunction,while the E peak and EF slope rate are the best for diastolic dysfunction.

关 键 词：冠状动脉疾病/病理生理学 心室功能 左 心缩期 

分 类 号：R541.4[医药卫生—心血管疾病]