声学定量方法动态评价房颤时右心房结构和功能的研究  

Dynamic evaluation of the right atrial structure and function in atrial fibrillation using the acoustic quantification technique

作　　者：周风华[1] 钟明[1] 杨贵荣[2] 王媛媛[1] 张薇[1] 黎莉[1] 张运[1] 

机构地区：[1]山东大学齐鲁医院心内科教育部和卫生部心血管重构与功能研究重点实验室,山东济南250012 [2]武警总医院重症监护科,北京100039

出　　处：《山东大学学报（医学版）》2007年第9期865-867,885,共4页Journal of Shandong University:Health Sciences

基　　金：国家自然科学基金资助课题(30370564);山东省卫生厅科研基金资助课题

摘　　要：目的:应用声学定量方法动态评价房颤时右心房结构和功能的变化。方法:通过快速心房起搏建立慢性房颤动物模型,采用声学定量方法(AQ)动态监测对照组(n=6只)和房颤组(n=8只)犬,起搏前、起搏14、、8周时右心房容量-时间曲线。结果:与对照组相比,起搏4周后,房颤组右心室收缩末期右心房容积(ESV),右心室舒张末期右心房容积(EDV),右心房快速排空期末容积(EREV)开始增加,右心房射血分数(EF),右心房管道容积(CV)降低(P均<0.05);起搏8周后,ESV,EDV,EREV增加显著(P均<0.001),而EF峰值、心房排空率(PAER)降低显著(P均<0.001),CV亦明显降低(P<0.05),余指标在起搏过程中无明显改变。与起搏前相比,房颤组起搏1周后右心房AQ各项指标均无明显改变(P>0.05);起搏4周后ESV、EREV、EDV增加(P<0.05),EF降低(P<0.05);起搏8周后ESV、EREV、EDV显著增大(P<0.001),EF和PAER降低(P<0.001);与起搏1周相比,起搏8周后ESV,EREV,EDV增大(P<0.01),EF和PAER减低(P<0.01);余指标在起搏过程中差异无统计学意义。结论:房颤时右心房的助力泵功能和管道功能减低,而储存器功能无明显改变;AQ技术为无创性评价房颤时右心房结构和功能的改变提供了有效方法。Objective： To evaluate the dynamic changes of the fight atrial structure and function in atrial fibrillation using the acoustic quantification （AQ） technique. Methods： Dog models with chronic atrial fibrillation were established by rapid atrial pacing. Right atrial AQ waveforms were recorded before rapid atrial pacing and after pacing for 1, 4 and 8 weeks. Results： Compared with the control group, ESV, EDV and EREV of the atrial fibrillation group were increased, and EF and CV were decreased （ P 〈 0.05） at 4 weeks after pacing. And 8 weeks after pacing, ESV, EDV and EREV were significantly increased （P 〈 0.001）, while EF and PAER significantly decreased （P 〈 0.001） and CV was also significantly decreased （ P 〈 0.05）, and the other parameters had no significant changes in the pacing progress. In the atrial fibrillation group, compared with those before pacing, right atrial AQ parameters had no significant changes at 1 week after pacing （ P 〉 0.05） ; ESV, EREV and EDV were significantly increased （ P 〈 0.05） and EF was signifi- cantly decreased （ P 〈 0.05） at 4 weeks after pacing, while ESV, EREV and EDV were significantly increased （ P 〈 0.001 ） and EF and PAER were significantly decreased （ P 〈 0.001 ） at 8 weeks after pacing. Compared with the 1-week group, ESV, EREV and EDV were significantly increased （ P 〈 0.01 ） and EF and PAER were significantly decreased （P 〈 0.01） at 8 weeks after pacing, and other parameters had no statistical significance. Conclusions： Atrial fibrillation may result in right atrial booster pump and conduit function impairment but no changes of reservoir function. AQ technique may be used as a valuable noninvasive method for evaluating right atrial structure and function in atrial fibrillation.

关 键 词：声学定量 心房颤动 心房功能 右 

分 类 号：R543[医药卫生—心血管疾病]