组织多普勒成像定量评价左室舒张功能  

Quantitative evaluation of left ventricular diastolic function by doppler tissue imaging

作　　者：郑道文[1] 宾建平[1] 农盛雄[2] 罗建春[3] 王鹏[1] 劳翼[1] 吴平生[1] 

机构地区：[1]南方医科大学南方医院心内科,广东广州510515 [2]惠州市中心医院心内科,广东惠州516001 [3]解放军第303医院老干所,广西南宁530021

出　　处：《中国现代医学杂志》2008年第15期2216-2219,2222,共5页China Journal of Modern Medicine

基　　金：国家"863"计划项目(No:2006AA02Z478)

摘　　要：目的应用组织多普勒成像技术(DTI)与左室舒张末压(LVEDP)对比评价左室舒张功能,探讨DTI评价左室舒张功能的临床价值。方法选取33名患者,分为左室肥厚组(LVH)与非左室肥厚组(non-LVH),另选取15名健康人作为对照组,分别行超声多普勒及DTI检查,多普勒超声测量二尖瓣口舒张早期充盈速度(E)和舒张晚期充盈速度(A)及E/A,DTI模式测量二尖瓣环舒张早期运动速度(Ve)、舒张晚期运动速度(Va)和Ve/Va,以及用猪尾导管直接测量LVEDP。结果实验组Ve/Va和E/A均比对照组显著减小(P<0.05),且LVH组Ve/Va比non-LVH组减小更为显著(P<0.05),而LVH组E/A与non-LVH组相比差异无显著性(P>0.05)。LVEDP与Ve/Va、E/A呈负相关(r分别为-0.92和-0.79,P<0.05),室间隔厚度(IVSd)与Ve/Va、E/A呈负相关(r分别为-0.67和-0.49,P<0.05),Ve/Va与LVEDP的相关性高于E/A与LVEDP的相关性。结论DTI可作为评价左室舒张功能的可靠方法。[Objective] To evaluate the value of DTI in detecting left ventricular（LV）diastolic function. The findings were compared with those of left ventricular end-dlastolic pressure（LVEDP）. [Methods] According to the presence or absence of LVH, 33 patients between 40 and 76 years were divided into the LVH（n =18） and non-LVH（n = 15） groups. In addition,fifteen healthy control subjects were enrolled. The standard 2D echocardiography, standard Doppler and DTI were performed to measure early diastolic velocities （Ve）, late diastolic velocities（Va） and transmitraldiastolic early-to-late filling velocities （E and A）, respectively. To analyze invasively LVEDP with fluid-filled catheter. [Results] The ratio of Ve/Va or E/A in the LVH and non-LVH groups were significantly lower than that of the control group （P 〈0.05）. A further decrease in the ratios of Ve/Va was seen in LVH as compared with non-LVH （P 〈0.05）. There was no significant difference in the ratio of E/A between the LVH and non-LVH groups （P 〉0.05）. There was a close relationship between LVEDP and Ve/Va or E/A （P 〈0.05, r =-0.92 and -0.79, respectively）, a similar linear relationship was observed between IVSd and Ve/Va or E/A （P 〈0.05, r =-0.67 and -0.49, respectively）, the relationship LVEDP versus Ve/Va was significantly higher than that versus E/A. [Conclusion] DTI could provide reliable parameters to evaluate LV diastolic function.

关 键 词：组织多普勒成像技术 左室肥厚 左室舒张功能 左室舒张末压 超声心动图 

分 类 号：R541.4[医药卫生—心血管疾病]