扩张型心肌病左室重构的形态学评价及与心功能的关系  

Evaluation of left ventricular remodeling and function in dilated cardiomyopathy by echocardiography

作　　者：吴棘[1] 李智贤[1] 郭盛兰[1] 何云[1] 张棣[1] 刘福元[2] 

机构地区：[1]广西医科大学附属第一医院超声诊断科,广西南宁530021 [2]华中科技大学同济医学院心内科,湖北武汉430022

出　　处：《中国临床医学影像杂志》2006年第6期304-306,共3页Journal of China Clinic Medical Imaging

基　　金：广西科学基金资助项目(NO.桂科攻0235024-4)

摘　　要：目的:探讨扩张型心肌病(DCM)左心室几何重构的形态学评价指标及其与心功能的关系。方法:运用多普勒超声心动图检测左心室球形指数(SI)、D2EL、(D1+D2+D3)E3L、D3-D2、D2-D1、(D2-D1)ED2、2D1EL,进行左室形态学评价,分析各指标与心功能的关系。结果:DCM患者SI显著降低,D2EL、(D1+D2+D3)E3L、2D1EL显著升高,D2-D1增大,但(D2-D1)ED2与对照组比较无统计学差异,D3-D2出现负值的几率显著高于对照组。DCM组射血分数(EF)、每搏量(SV)显著降低。SI与EF、SV显著正相关,D2EL、(D1+D2+D3)E3L、2D1EL与EF、SV显著负相关。结论:运用多个形态学指标可以较全面地评价DCM左心室几何重构,其中2D1EL可更好地反映左室心尖部球形化,SI与2D1EL相结合可作为左室形态学评价的一个优化指标体系,为临床更全面地了解DCM左心室几何重构及心功能、拟定治疗方案、估测预后提供更多选择。Objective： To explore some indices for geometric evaluating left ventricular remodeling and their relationship with left ventricular function in dilated cardiomyopathy（DCM）. Methods： A series of geometric indices such as sphericity index （SI）, D/L, （D1＋D2＋D3）/3L, D3-D2, D2-D1, （D2-D1）/D2 and 2D1/L were measured by echocardiography to describe left ventricular shape. Results： SI significantly decreased and D2/L, （D1＋D2＋D3）/3L, 2D1/L markedly increased in DCM compared with normal subject. D2-D1 also rised in DCM, but （D2-D1）/D2 did not show statistical difference in contrast to that of the control group. There was a significantly high frequency that D3-D2 was negative in DCM than in normal subject. Ejection fraction（EF） and stroke volume（SV） decreased markedly in DCM. Moreover, EF and SV were significantly positively related with SI, and negatively related with D2/L, （D1＋D2＋D3）/3L, 2D1/L. Conclusion： Left ventricular remodeling in DCM could be described more completely by several geometric indices than by only one index. Especially 2D1/L, which was a sensitive index to sphericity of apex, SI combined with 2D1/L as an improved system for geometric evaluation could provide more morphologic information about left ventricle.

关 键 词：心肌病 扩张型 超声心动描记术 

分 类 号：R542.2[医药卫生—心血管疾病] R540.45[医药卫生—内科学]