脉冲多普勒组织成像评价冠心病左心室功能的应用  

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

作　　者：李建辉[1] 李泉水[2] 郑隆权[1] 

机构地区：[1]广州市番禺区人民医院超声科,广东广州511400 [2]深圳市第二人民医院超声科,广东深圳518035

出　　处：《深圳中西医结合杂志》2008年第3期155-158,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:探讨应用脉冲多普勒组织成像(PW-DTI)技术定量评价冠心病患者左心室舒张收缩功能的临床应用价值。方法:用PW-DTI技术检测60例临床疑诊为冠心病患者二尖瓣环舒张早期运动速度(Ea)、舒张晚期运动速度(Aa)和收缩期运动速度(S),并用脉冲多普勒法和改良simpson's法分别测量二尖瓣口舒张早期血流速度(E)、舒张晚期血流速度(A)和左室射血分数(EF),比较两组参数的不同。结果:冠状动脉造影检查及心电图检查,60例患者中正常对照组(A组)22例、冠心病非心肌梗塞组(B组)26例,心肌梗塞组(C组)12例。①A组与B组的A、E/A,Ea与Ea/Aa比值4个参数存在显著性差异(P<0.05),余参数相差不显著;②A组与C组除A、Aa外,其余各参数均存在显著性差异(P<0.05);③B组与C组的S,EF存在显著性差异(P<0.05);④各组间E/A与Ea/Aa,S与EF之间均存在正相关关系(P<0.005)。结论:TI技术检测二尖瓣环舒张期及收缩期运动速度参数可用于定量无创评价冠心病患者的左心室功能损害程度,较传统超声心动图测量左心室功能更简便、准确。Objective To assess the clinical value of Doppler tissue imaging （DTI） in evaluating left ventricular diastolic and systolic function in patients with coronary artery disease （CAD）. Methods Mitral annular early diastole （Ea）, late diastole （Aa） and systolic （S） velocities of 60 patients suspected CAD measured by pulsed wave DTI and mitral annular inflow velocities E, A and left ventricular eject fraction （EF） measured by conventional echocardiography were analyzed. Results 22 normal controls （Group A） and 38 patients with CAD confirmed by coronary angiography were examined, including 26 patients with nonmyocardial infarction （Group B） and 12 patients with myocardial infarction （Group C）. Compared among the three groups, ①the mean Ea, S, Ea/Aa and E, E/A, EF of the mitral annulus in group C were significantly lower than those of group A （P 〈 0.05）, ②There were significant difference of A, Ea, Ea/Aa and E/A between group A and group B （P 〈 0.05）. ③Between group B and C, S and EF showed significant difference （P 〈 0.05）. ④There were significant correlations between Ea/Aa and E/A, S and EF in three groups （P 〈 0.005）. Conclusion Mitral annular diastolic and systolic velocities parameters measured by DTI can quantitatively be used in assessment of left ventricular function in CAD. The index of Ea/Aa measured by DTI is better than the ratio of E/A measured by conventional Doppler for evaluating the left ventricular diastolic dysfunction. The mitral annular systolic velocity （S） can estimate left ventricular systolic function but can＇t replace the index of EF completely.

关 键 词：脉冲多普勒组织成像 冠心病 左心室功能 

分 类 号：R541.4[医药卫生—心血管疾病]