心阻抗法及超声心动图评价心脏左室收缩功能的相关性研究  

A Study on Utilization Impedance Cardiography to Detect Cardiac Systolic Dysfunction and its Correlation with Echocardiogram

作　　者：杨海燕[1] 苏立[1] 佘强[1] 田祥玉[1] 

机构地区：[1]重庆医科大学附属第二医院心内科,重庆400016

出　　处：《江西医学院学报》2006年第1期34-37,共4页Acta Academiae Medicinae Jiangxi

摘　　要：目的阻抗心电图(ICG)是一项无创的血流动力学检查方法,可以用于评估心脏收缩功能,本研究描述并比较了ICG在左室收缩功能正常和异常患者中的检测结果,并评估收缩时间比率(STR)与超声心动图中射学分数(EF)检测心脏收缩功能不全的相关性。方法选择住院患者139例,超声心动图测定EF值,ICG(BioZ,Cardio-Dynamics,CA)测定STR值(两者时间差小于24 h)。以EF 50%为标准分成心脏收缩功能正常组和异常组,分别行ICG检查测定其STR值,分析EF与STR的相关性。结果139例患者中,119(119/139)例EF≥50%伴低STR值(0.3824±0.0130,96/119例STR<0.5,23/119例STR≥0.5);20(20/139)例EF〈50%伴高STR值(0.6575±0.0378,3/20例STR<0.5,17/20例STR≥0.5)。低EF组显示高STR值,正常EF组显示低STR值,两者之间呈负相关(r=0.48,P<0.0001),回归方程为Y(EF)=82.38883-36.67085X(STR)。与超声心动图对比,STR检测心脏收缩功能不全(EF<50%)敏感性为85%,,特异性为81%.结论ICG中STR可以用于无创评估左室收缩功能不全,STR与EF呈负相关。心脏收缩功能不全患者STR值增大。Objective Impedance cardiography （ICG）is a noninvasive method capable of determining multiple hemodynamic parameters,which include indices of systolic cardiac function. This study described and differentiated the ICG findings of patients with normal and abnormal left ventricular systolic function,and evaluates the ability of systolic time ratio（STR）to detect systolic dysfunction as well as its correlation with the ejection fraction（EF）by echocardiogram. Methods 139 adult patients were included in this study. Impedance cardiography was done on admission and a transthoracic echocardiogram examination was done within 24 hours. The population was grouped into normal systolic function with normal EF（〉50%）,and abnormal systolic function with EF（〈50% ）based on echocardiographic evaluation. ICG parameters of STR were then described in the two groups. ICG parameters of systolic function were then compared and correlated with the echocardiographic parameters of ejection fraction. Results Of the 139 patients,119（119/ 139）had a normal EF（≥50%）and low STR（0. 3824±0.0130,96/119 patients＇ STR（0.5,23/119 patients＇ STR≥0. 5）, and 20（20/139）patients had a low EF（〈50%） and high STR（0. 6575±0. 0378,3/20 patients＇ STR（0.5,17/20 patients＇ STR≥0. 5）. For the group with a low EF,the ICG findings revealed a increased STR and in the group of normal EF,ICG showed a decreased STR. The regression equation was EF= 82. 38883-36. 67085STR（P〈0.0001） ,When compared with the echocardiogram,STR was 85 % sensitive and 81% specific in detecting systolic dysfunction（EF〈50%）. Correlation studies using the STR against the presence of systolic dysfunction （EF〈50%） showed moderately negative correlation（r=0.48,P〈0.0001）. Conclusions The parameter STR of ICG is useful in the noninvasive hemodynamic assessment of left ventricular systolic dysfunction patients. STR correlates negatively with the EF in the detection of systolic dysfunction. Patients with systolic dys

关 键 词：射血分数 收缩时间比率 心窒收缩功能 

分 类 号：R540.45[医药卫生—心血管疾病]