缺血性心肌病的左心室舒张功能障碍和预后  

The prognosis of left ventricular diastolic dysfunction in patients with ischemic cardiomyopathy

作　　者：李恒青 郭顺华 姚楠 韦建瑞 

机构地区：[1]暨南大学医学院附属广州红十字会医院,广州510000

出　　处：《岭南心血管病杂志》2006年第4期245-247,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨缺血性心肌病(ischemiccardiomyopathy,ICM)左心室舒张功能不全与病死率的关系。方法应用多普勒超声测定ICM35例的二尖瓣和肺静脉血流频谱,分析11项参数与正常组进行比较。ICM组再分成非限制型和限制型充盈障碍亚组。对ICM病例进行8个月～5年的观察及死亡病因的调查。结果正常组与ICM组比较,二尖瓣E峰最大峰值(peakvelocityatearlydiastole,MV-E)、E/A比值(E/Aratio)、E峰减速时间(Ewavedecelerationtime,EDT);PV-S峰、D峰、S/DT、S/D比值,EPSS差异有统计学意义(P<0.05)。非限制型和限制型充盈障碍亚组比较,左心室射血分数差异无统计学意义(P>0.05),MV、PV指标,EPSS差异有统计学意义(P<0.05)。非限制型充盈障碍亚组病死率27%(4/15)。检查至死亡时间(24±8)个月;限制型充盈障碍亚组病死率55%(11/20)。检查至死亡时间(11±8)个月,心力衰竭是死亡主要原因。非限制型充盈障碍亚组与限制型充盈障碍亚组间差异有统计学意义(P<0.05)。结论左心室舒张功能不全是心力衰竭的一个重要表现。限制性充盈异常与重度收缩功能不全有关,是严重充血性心力衰竭的标志,病死率高。Objectives To explore the relationship between left ventricular diastolic dysfunction of ischemic cardiomyopathy（ICM） and death ratio. Methods To measure blood flow frequency spectrum of the mitral valve and pulmonary veins in 35 cases of ICM patients by Doppler ultrasound, analyse 11 data, and to compare with the normal group. ICM group was divided into two subgroups： Non-restrictive Idling defect（NRF）and restrictive Idling defect（RF）. Detective analysis for ICM cases, under observation and death cause study,had been going on for the period from 8 months to 5 years. Results Normal group compared to NRF group, RF group, all the following indexes had difference： MVE peak, E/A ratio, EDT; PVS peak, D peak, S/DT, S/D ratio, EPSS. P〈0.05; NRF group compared to RF group, LVEF had no great difference, P〉0.05, MV PV marker, EPSS had difference,P〈0.05; NRF death ratio was 27%（4/15）. Average time from begin to death was （24±8） months. RF group death ratio was 55% （11/20）. Average time from begin to death was （11±8） months,heart failure was the key point for death. NRF group and RF group had great difference in death ratio and death time, P〈0.05. Conclusions Doppler ultrasound technique is a practical, convenient, accuracy method to study left ventricle function. Left ventricular diastolic dysfunction is an important factor to heart failure. Restrictive Idling defect related to severe systolic dysfunction, is a symbol to servere congestive heart failure, and has high death ratio. It must be paid much attention to diagnosis and cure in time to reduce death ratio. .

关 键 词：舒张功能障碍 缺血性心肌病 多普勒超声 病死率 

分 类 号：R542.2[医药卫生—心血管疾病]