超声心动图与导管法在评价冠心病左室舒张功能中的对比研究  

Study on the evaluation of left ventricular diastolic function by echocardiogram or coronary angiography

作　　者：吴长君[1] 赵鸿雁[1] 李玉丹[1] 张蕊[1] 

机构地区：[1]哈尔滨医科大学第一临床医学院超声科,150001

出　　处：《中国急救医学》2007年第5期414-416,共3页Chinese Journal of Critical Care Medicine

基　　金：哈尔滨市培养学科后备带头人基金项目(No.2002AF××J056)

摘　　要：目的探讨应用多普勒超声心动图测量舒张早期心室内充盈离散与心导管法对比评价左室舒张功能。方法连续观察120例冠心病患者,均行经胸多普勒超声检查和冠状动脉及左室造影检查。超声心动图检查:心尖四腔切面将多普勒取样线置于左房室口至心尖连线,将取样容积放置左房室口处测量左房室口舒张期血流峰值速度A0、E0及A0/E0比值,及离左房室瓣尖1、2、3cm处测量离瓣尖1、2、3cm舒张早期血流速度En(E1、2、3),计算En与E0比值。根据心导管实测左室舒张末压(LVEDP)15mmHg为界分为两组:正常组(LVEDP≤15mmHg)和升高组(LVEDP>15mmHg)。结果心导管检查中最大左室舒张速率、等容舒张时间常数两组间比较差异无统计学意义(P>0.05);LVEDP、左室压力最大下降速率时对应的左室压力、左房收缩前左室舒张速率两组间比较差异有统计学意义(P<0.05)。升高组左室舒张早期血流速度从左房室口至心尖逐渐降低,舒张期心内充盈离散E3及E3/E0比值与E0及E1/E0比值比较差异有统计学意义(P<0.05)。结论左室内充盈离散度E3/E0可用于评价冠心病患者左室舒张功能,是测定冠心病左室舒张功能的一种简便有效的方法。Objective To evaluate the left intraventricular diastolic function of patients with coronary artery diseases by the left dispersion of peak early diastolic flow velocity and coronary angiography. Methods Mitral Doppler signals were recorded by the continuous wave Doppler technique in 120 patients, both coronary angiography and left ventricle pressure were measured. Patients were divided into two groups according to left ventricular end - diastolic pressure （ LVEDP ） during cardiac catheterization ： normal group（ LVEDP≤15 mm Hg） , the elevated group（ LVEDP 〉 15 mm Hg）. Doppler echocardiogram studies were obtained from mitral tip toward the apex （ E0, E1, E2, and E3 ） ： that is, mitral flow velocity （ E0） and the early diastolic flow velocity at 1cm, 2cm, 3cm from mitral tip toward the apex. Results LVEDP,the left ventricular negativeAp/At before atria contraction and -dp/dt in elevated group were more than those in the normal. Intraventricular dispersion of early diastolic filling were significantly lower in elevated group than in normal group （P 〈 0.05）. The early diastolic flow velocity were progressively decreased from the tip toward the apex in elevated LVEDP patients. In early diastolic flow velocity, E3 and E3/E0 ratio were progressively and significantly lower than E0 and E1/E0 ratio （ P 〈0.05 ）. Conclusions The intraventricular dispersion of peak early diastolic flow velocity E3 and E3/E0 ratio may be useful in detecting LV diastolic function in CAD with elevated LVEDP patients.

关 键 词：超声心动图 心导管 左室内充盈离散度 

分 类 号：R541.4[医药卫生—心血管疾病]