二尖瓣环运动速度对心力衰竭患儿左心室功能评价的应用价值  

Assessment of left ventricular function by mitral annular velocity in heart failure children

作　　者：刘雪芹[1] 宋秀婷[1] 王瑜丽[1] 杜军保[1] 陈永红[1] 李万镇[1] 

机构地区：[1]北京大学第一医院,北京100004

出　　处：《中国实用儿科杂志》2007年第6期431-433,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨心力衰竭患儿二尖瓣环运动速度的变化及其在左心室功能评价中的应用价值。方法研究对象为2005-01—2006-05在北京大学第一医院儿科住院的21例左室扩大及左室射血分数<50%的心力衰竭患儿(心衰组)和21例正常儿童(对照组),对其行常规超声心动图检查,测量左室射血分数(LVEF)、二尖瓣口前向血流E峰和A峰的峰值流速,计算E/A值;以组织多普勒成像(TDI)脉冲多普勒速度频谱显像方法测量二尖瓣环侧壁及间壁收缩期峰值速度(Sa)、舒张早期峰值速度(Ea)及舒张晚期峰值速度(Aa),分别计算Ea/Aa值及E/Ea值。结果心衰组二尖瓣环侧壁及间壁Sa、Ea、Ea/Aa均显著低于对照组(P均<0.01),两部位E/Ea均显著高于对照组(P均<0.01);心衰组二尖瓣环两部位Sa、侧壁Ea均与LVEF正相关((r=0.60,0.44,0.52,P均<0.05),两部位Sa、Ea均与心功能分级负相关(r=-0.64,-0.55,-0.68,-0.54,P均<0.05),两部位E/Ea均与LVEF负相关(r=-0.59,-0.47,P均<0.05)、与心功能分级正相关(r=0.77,0.75,P均<0.001)、二尖瓣环侧壁及间壁Sa与相应部位Ea、E/Ea有相关性。结论常规超声检查左室收缩功能下降的心力衰竭患儿左室收缩及舒张功能均降低,且二者有密切联系;以TDI方法测定二尖瓣环运动频谱评价心力衰竭儿童左室功能是敏感和可靠的。Objective To investigate the change of mitral velocity by tissue Doppler imaging（TDI） and to evaluate the value of TDI method in the assessment of left ventricular function in heart failure children. Methods The study consisted of two groups： heart failure （HF） group consisted of 21 children aged 8 months to 17 years with heart failure （ HF group） and left ventricular enlargement and a left ventricular ejection fraction（LVEF） 〈 50% ,heart function was graded by NYHA;another 21 age-and sex-matched normal children were as the control group. Conventional echoeardiography was done to obtain left ventricular ejection fraction （LVEF） and transmitral inflow E and A wave velocities and E/A ratio. Pulsed wave TDI velocities were obtained in the lateral and septal mitral annulus （ MA-L, MA-S） separately and Sa, Ea and Aa velocities were masured;Ea/Aa and E/Ea were calculated. Results Sa,Ea and Ea/Aa at both site of the mitral annulus were significantly lower （ P all 〈 0. 01 ）, and E/Ea significantly higher （ P all 〈 0. 01 ） compared with that of the control group respectively. Sa of both sites and Ea of MA-L correlated positively with LVEF [ r = 0. 60,0. 44,0. 52, P all 〈 0. 05 ） ; Sa and Ea of both sites correlated negatively with NYHA grading（ r = - 0. 64, -0. 55, - 0. 68, - 0. 54, P all 〈 0. 05 ） ; E/Ea correlated negatively with LVEF （ r = - 0. 59, - 0. 47, P all 〈 0.05 ） and positively with NYHA grading （ r = 0.77,0.75, P all 〈 0. 001 ）. Sa also correlated closely with Ea and E/Ea at each site. Conclusion Children with heart failure have both left ventricular systolic and diastolic disfunction, and they have a close correlation. Mitral annulus velocity detected by TDI is sensitive and reliable to evaluate left ventficular function in heart failure children.

关 键 词：组织多普勒成像 心力衰竭 左心室功能 儿童 

分 类 号：R72[医药卫生—儿科]