组织多普勒成像评价左心室舒张功能障碍患者的左心室长轴收缩功能  

Tissue Doppler imaging assessment of left ventricular long-axis systolic function in patients with left ventricular diastolic dysfunction

作　　者：王志斌[1] 宋明芳[2] 乐嘉芳[3] 

机构地区：[1]青岛大学医学院附属医院心脏超声科,青岛266003 [2]济南军区青岛第二疗养院特诊科 [3]青岛大学医学院附属青岛市立医院超声科

出　　处：《中华医学超声杂志（电子版）》2006年第2期91-93,共3页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨左心室舒张功能障碍患者的左心室长轴收缩功能变化特征。方法选取健康志愿者30例(Ⅰ组),左心室舒张功能障碍患者60例分为松弛性减低组(Ⅱ组)32例和假性正常化充盈组(Ⅲ组)28例,应用组织多普勒成像(TDI)模式,分别取心尖四腔心和二腔心切面,将取样容积先后置于二尖瓣环后间隔、侧壁、前壁和下壁处,记录4个位点二尖瓣环运动频谱,测量或计算舒张早期峰值速度(EM)、心房收缩期峰值速度(AM)、EM/AM比值、收缩期峰值速度(SM)、收缩期位移(DS,即收缩波时间速度积分)及收缩前期时间(PCTM,即心电图QRS波起始与收缩波起始之间期),并对3组数据进行比较分析。结果SM和DS在Ⅱ、Ⅲ组明显小于Ⅰ组(P<0.01或P<0.05),在各组间呈逐渐减小趋势,即Ⅰ组>Ⅱ组>Ⅲ组;而各组间PCTM差异无统计学意义(P>0.05)。左心室长轴收缩功能减低发生率在Ⅱ、Ⅲ组分别是35.3%和67.2%(P<0.01)。结论左心室舒张功能障碍患者存在一定程度长轴收缩功能障碍,且其受损程度随着舒张功能障碍进展而加重,因而采用TDI评估左心室长轴收缩功能对全面评价患者心脏功能具有重要价值。Objective To detect the alteration of left ventricular long-axis systolic function in patients with left ventricular diastolic dysfunction. Methods Using tissue Doppler imaging, the mitral annular systolic peak velocity （ SM ）, the displacement （ DS ） and the pre-contraction time （ PCTM ） were measured in 30 healthy volunteers （ GroupⅠ）, 32 patients with abnormal relaxation （ GroupⅡ） and 28 patients with pseudonormal filling （GroupⅢ）. Results SM and Ds in group Ⅱ and Ⅲ were significantly lower than in group Ⅰ（P 〈 0.01 ）. There were significant step-down changes from group Ⅰ to Ⅲ. No significant differences existed in PCTM among the four groups （ P 〉 0.05 ）. The incidence of long axis systolic dysfunction in group Ⅱ and Ⅲ was 35.3% and 67.2% （ P 〈 0.01 ）, respectively. Conclusions The left ventricular systolic long-axis dysfunction existed in patients with left ventricular diastolic dysfunction and it deteriorated as the severity of left ventricular diastolic dysfunction progressed. Assessing left ventricular long-axis systolic function using tissue Doppler imaging is of important value in the comprehensive evaluation of cardiac function.

关 键 词：超声心动描记术 左心室功能 组织多普勒成像 

分 类 号：R445.1[医药卫生—影像医学与核医学]