多普勒组织成像评价风湿性二尖瓣狭窄患者左心室长轴收缩功能  

Evaluation of left ventricular long-axis systolic function in patients with rheumatic mitral stenosis using Doppler tissue imaging

作　　者：王志斌 [1] 牛晓燕 [2] 李艳 [1] 聂晶 [1] 孙品 [1] 

机构地区：[1]266003,青岛大学医学院附属医院心脏超声科 [2]青岛大学医学院研究生

出　　处：《中华医学超声杂志（电子版）》2005年第2期86-89,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨多普勒组织成像(DTI)技术评价风湿性二尖瓣狭窄(MS)患者左心室长轴收缩功能的临床意义.方法选取单纯性MS患者67例,根据射血分数(EF)将MS患者分为EF正常MS组57例,其EF＞50%,EF减低MS组10例,其EF≤50%,另选健康志愿者50例作为对照组,应用DTI检测MS组和对照组的二尖瓣环收缩期峰值运动速度(SM)、收缩期位移(DS)、收缩前期时间(PCTM)、收缩时间(CTM),并计算PCTM/CTM比值.结果 SM及DS在对照组、EF正常MS组和EF减低MS组呈逐渐减小,EF正常MS组和EF减低MS组显著小于对照组(P<0.01),且EF减低MS组显著小于EF正常MS组(P<0.01).PCTM/CTM比值在3组间呈逐渐增大,EF正常MS组和EF减低MS组大于对照组(P<0.05或P<0.01),且EF减低MS组大于EF正常MS组(P<0.05).左心室长轴收缩功能异常发生率在EF正常MS组和减低MS组分别为60.2%和100%(P<0.01).直线相关分析显示,SM、DS和PCTM/CTM比值与二尖瓣口面积(MVA)低度相关(分别为r=0.48,P<0.01;r=0.35,P<0.01;r=-0.26, P<0.05).结论在左心室短轴收缩功能减低之前,MS患者已经存在左心室长轴收缩功能障碍,应用DTI检测左心室长轴收缩功能对MS患者心功能的全面评估具有重要价值.Objective To investigate the clinical significance of Doppler tissue imaging （DTI） in the evaluation of left ventricular long-axis systolic function in patients with rheumatic mitral stenosis （MS）. Methods Sixty-seven patients with isolated MS were selected. According to the left ventricular ejection fraction （EF）, 67 patients were further divided into two subgroups, i. e. , normal EF group （EF 〉50% ） consisting of 57 patients and decreased EF group （EFt〈50%） consisting of 10 patients. Fifty healthy volunteers were selected as the control group. Using DTI, the mitral annular systolic peak velocity （ SM ） , the systolic excursion （ Ds ） , the pre-contraction time （ PCTM ） , contraction time （ CTM ） and PCTM/CTM ratio were measured in MS and the control group. Results There was a significant step-down change from the control, normal EF toward the decreased EF group in SM and Ds, which were significantly lower in either the normal EF or decreased EF group than that in the control group （P 〈 0.01 ） , and in the decreased EF group than that in the normal EF group （P 〈 0.01 ）. There was a significant step-up change among the three groups in PCTM/CTM ratio, which was higher in either the normal EF or decreased EF group than that in the control group （P 〈 0.05 or P 〈 0.01 ） , and in the decreased EF group higher than in the normal EF group （ P 〈 0.05 ）. The incidences of left ventricular long-axis systolic dysfunction in the normal EF and decreased EF groups were respectively 60.2% and 100% （P 〈 0.01 ）. Linear correlation analysis showed that SM, Ds and PCTM/CTM correlated with mitral valvular area （r=0. 48, P〈0. 01; r=0. 35, P〈0. 01; r= -0.26, P〈 O. 05 ,respectively）. Conclusions Left ventricular long-axis systolic dysfunction precedes the decrease of left ventricular short-axis function in patients with MS. Detecting the left ventricular long-axis systolic function using DTI is of important value in the comprehensive evaluation of cardiac

关 键 词：多普勒超声心动描记术 二尖瓣狭窄 左心室功能 多普勒组织成像 风湿性二尖瓣狭窄 收缩功能障碍 左心室短轴 患者 长轴 二尖瓣环收缩期 

分 类 号：R654.2[医药卫生—外科学] R541.6[医药卫生—临床医学]