脉冲多普勒组织成像评价冠心病患者左室舒张功能  

Assessment of Left Ventricular Diastolic Function in Patients with Coronary Artery Disease by Pulsed Doppler Tissue Imaging

作　　者：杨莉[1] 伍卫[1] 王景峰[1] 张小玲[1] 

机构地区：[1]中山大学附属第二医院心内科,广东广州510120

出　　处：《中山大学学报（医学科学版）》2007年第2期180-183,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省自然科学基金资助项目(031706)

摘　　要：【目的】探讨脉冲多普勒组织成像(DTI)评价冠心病患者左室舒张功能异常的价值,以及舒张早期二尖瓣血流与瓣环运动峰值速度的比值(E/Em)在评价左室舒张功能异常中的意义。【方法】冠心病心绞痛组16例、心肌梗死组34例,对照组16例。常规测定二尖瓣血流频谱。脉冲DTI记录二尖瓣环侧壁、间隔、前壁和下壁的运动频谱,测量舒张早、晚期峰值运动速度及其比值,计算4个位点的均值,分别以Em、Am、Em/Am表示,并计算E/Em比值。【结果】心绞痛组和心肌梗死组Em、Em/Am较对照组显著降低,分别为12.3±1.6、10.7±1.8vs16.7±1.8和0.8±0.2、0.7±0.2vs1.2±0.2,均为P<0.01;心肌梗死组Em较心绞痛组更低,10.7±1.8vs12.3±1.6,P<0.01。心肌梗死组较对照组和心绞痛组E/Em显著增大,7.3±2.1vs5.5±1.4、5.9±1.5,P<0.01、P<0.05。【结论】脉冲DTI所测Em、Em/Am可反映冠心病患者左室舒张功能异常,E/Em有助于鉴别二尖瓣血流频谱假性正常化。[Objective] To explore the value of pulsed Doppler tissue imaging （DTI） in the assessment of left ventricular diastolic dysfunction in the patients with coronary artery disease （CAD）, and to investigate the usefulness of the ratio of early diastolic transmittal flow velocity and mitral annulus motion velocity （E/Era） for evaluation of left ventricular diastolic dysfunction. [Methods] Fifty patients with CAD were divided into angina pectoris （AP, 16 cases） and myocardial infarction （MI, 34 cases） groups. Sixteen age-matched healthy individuals were served as the control group. Transmitral flow spectrum was conventionally measured. The lateral, septal, anterior, and inferior walls of the mitral annulus were displayed, and selected for DTI spectrum sampling. Peak early and late diastolic velocities and their ratio were measured, and the mean values of the four mitral annular sites were calculated and presented as Era, Am, and Em/Am, respectively. E/Era ratio was also calculated. [Results] Compared with the control group, Em and Era/Am were significantly lower in both the AP and the MI groups （12.3±1.6 or 10.7±1.8 vs 16.7±1.8, and 0.8± 0.2 or 0.7±0.2 vs 1.2±0.2, respectively, all with P〈 0.01）. Em was even lower in the MI group than in the ALP group （10.7±1.8 vs 12.3±1.6, P〈 0.01）. E/Era was significantly larger in the MI group than in the control and the AP groups （7.3±2.1 vs 5.5±1.4 or 5.9±1.5, P〈 0.01, P〈 0.05）. [Conclusions] Em and Era/Am as measured by pulsed DTI can reflect left ventricular diastolic dysfunction in CAD patients. E/Em may be useful in the identification of a pseudonormal mitral inflow pattern.

关 键 词：多普勒组织成像 超声心动描记术 冠心病 左室舒张功能 

分 类 号：R540.45[医药卫生—心血管疾病] R542.22[医药卫生—内科学]