心肌收缩能力变化趋势与最大弹性模量的对照研究及其临床应用  

Comparative study of cardiac contractility change trend with maximum elasticity and the clinical application

作　　者：马康华[1] 葛平[1] 雷寒[1] 廖慧[1] 王志华[1] 肖守中[2] 

机构地区：[1]重庆医科大学第一附属医院,400016 [2]重庆大学生物医学工程系

出　　处：《重庆医学》2005年第4期571-573,共3页Chongqing medicine

摘　　要：目的　用最大弹性模量来评估基于心脏振动信号的心脏储备的无创检测方法的应用价值,并分析这两种无创方法之间的相关性。方法　在方法评估研究(研究I)中纳入正常对照受试者20例和高血压患者40例,不伴左室肥厚或心室扩大高血压患者20例作为HA组,有心室肥厚者20例作为HB组, 60 例都进行心音图运动试验,测量各受试者的心肌收缩能力变化趋势(CCCT)和利用心脏彩色超声心动图测量最大弹性模量(Emax),然后对两种检查所获得的指标进行相关性分析。方法应用研究(研究II): 另50人自愿加入该方法的临床应用研究,完成6min步行试验运动后S1 幅值对安静时S1 幅值增加的相应倍数定义为心力变化趋势CCCT(6′)。结果　(1)Emax指标: 除HA组外,对照组与HB组间及HA、HB两组间有显著性差异(P<0.05);(2)CCCT:对照组与高血压各组以及高血压病各组间均有显著性差别(P<0.01);(3)CCCT与Emax的相关系数r=0.702,P<0.01。研究II: 35个心血管病患者和19个无心血管病者心肌收缩能力变化趋势测试数据分别为:3.47±1.17和8.06±1.44 ,组间存在显著的差异(P<0.01)。结论　与超声最大弹性模量对比结果提示心肌收缩能力变化趋势指标可以用来评估心脏储备功能;Objective To study the applied values of a noninvasive method for evaluating the cardiac reserve function based on the cardiac vibratory signal by using of the maximum elasticity (Emax), and to analyze the correlation between two kinds of noninvasive examination.Methods In estimate study for this examination (study 1),sixty subjects including twenty normal contrasts and forty patients with hypertension ,twenty patients without left ventricular hypertrophy or ventricular enlargement defined as group HA and twenty ones without ventricular hypertrophy as group HB, were all examined for the cardiac contractility change trend (CCCT) by the phonocardiogram exercise testing and the Emax by color Doppler echocardiography.Then two kinds of data were analyzed for the correlation.In applying study for this exam (study 2),as another fifty persons were included,the increased ratio of the amplitudes of the first heart sound after 6min walk test to that recorded at rest was defined as CCCT(6′).Results (1)For Emax ,significant difference was detected not only between control group and group HB, but also the group HA and HB.(P< 0.05 ). (2)CCCT:there were significant differences among all the groups of contrast ,HA and HB. (3)The correlation coefficient between CCCT and Emax,r=0.702,P<0.01. Study 2:the CCCT(6′) of 35 cases with cardiology and 19 cases without that were respectively 3.47+1.17 and 8.06+1.44,and there was significant difference between these groups (P<0.01).Conclusion It was indicated that the cardiac reserve function could also be estimated by the examination of CCCT contrast to the Emax recorded by Doppler;the PCGET might be earlier to discover the decreasing cardiac reserve function than Doppler, and this kind of method could avoid the shortness of 6min walk test exam for the estimation of cardiac function. So it could be used to estimate the cardiac function at out-patient and in patient department as a noninvasive, safe, convenient, inexpensive,repeated and objective examination.

关 键 词：心音图运动试验 心肌收缩能力变化趋势 心脏储备 超声心动图 最大弹性模量 

分 类 号：R541.6[医药卫生—心血管疾病]