定量组织速度成像技术对心力衰竭患儿心脏非同步运动的研究  

Quantitative Tissue Velocity Imaging Eveluating on Ventricular Asynchrony in Children with Congestive Heart Failure

作　　者：滑少华[1] 秦石成[1] 张瑞芳[1] 程安玲[1] 

机构地区：[1]郑州大学第一附属医院超声科河南省高等学校临床医学重点学科开放实验室,郑州市450052

出　　处：《中国超声医学杂志》2008年第3期223-226,共4页Chinese Journal of Ultrasound in Medicine

基　　金：河南省自然科学基金资助项目(No.0611045000)

摘　　要：目的探讨定量组织速度成像(QTVI)评价充血性心力衰竭(CHF)患儿心室间及左心室内非同步运动的临床意义。方法正常小儿40例,CHF患儿30例,左心室内非同步性指标检测采取标准心尖四腔和两腔观,获得左心室4个壁基底段、中间段和心尖段共12个位点的QTVI曲线,测量各位点QRS波起点至心肌收缩期峰值速度和舒张早期峰值速度的时限(Ts和Te)。计算左心室同一壁内3个节段间Ts最大差值和Te最大差值(Intra-ΔTs和Intra-ΔTe)以及左心室12个心肌节段Ts和Te的最大差值(Max-ΔTs和Max-ΔTe)。心室间的不同步指标测量QRS波起点到主动脉瓣血流频谱起点时间(Q-A)、QRS波起点到肺动脉瓣血流频谱起点时间(Q-P)及其差值(Q-AP)。左室射血分数(LVEF)及Tei指数反映左心室整体功能。结果CHF组Intra-ΔTs和Intra-ΔTe、Max-ΔTs和Max-ΔTe、Q-A、Q-P及Q-AP较正常组明显延长。Max-ΔTs与LVEF负相关(r=-0.54,P<0.05;),与Tei指数正相关(r=0.58,P<0.01),与QRS不相关。Max-ΔTe与QRS正相关(r=0.57,P<0.01),与LVEF及Tei指数不相关。结论CHF患儿心室间及左心室内存在明显的非同步运动,且与心功能关系密切。Objective To evaluate the clinical value of the inter-and intraventricular asynchrony in the children with congestive heart failure （CHF） using quantitative tissue velocity imaging （QTVI）. Methods 40 normal children and 30 children with CHF were studied on QTVI. The regional velocity profiles in 12 segments of left ventride （LV） at LV apical four-chamber and two-chamber views were obtained. The time from onset of QRS complexes to peak velocity during systole and early diastole （Ts and Te） were measured. The maximal difference in Ts and Te within the same wall （Intra △Ts and Intra △Te） and all 12 segments Max △Ts and Max △Te of the LV were calculated. The time from onset of QRS complexes to beginning times of flow velocity spectra in aortic valve （Q-A） and pulmonary valve （Q-P） and their differences （Q-AP） were measured. The parameters of LV pump function included the ejection fraction of LV （LVEF） and Tei index were calculated. Results Intra-△Ts, Intra-△Te, Max-△Ts and Max-△Te, Q- A, Q-P and Q-AP in CHF group were significantly prolonged when compared with the control group. In CHF group, Max-△Ts was negatively correlated with LVEF （r= -0. 54, P〈0. 05） and positively with Tei index （r=0. 58, P〈 0.01 ） ,but it was not correlated with QRS duration. Max-ATe was positively correlated with QRS duration （r=0. 57, P 〈0. 01） and not correlated with LVEF and Tel index. Conclusions The inter-and intraventricular asynchrony exists in children with CHF and it has a good relation with LV function.

关 键 词：小儿 心力衰竭 心室功能 定量组织速度成像 

分 类 号：R725.4[医药卫生—儿科]