实时三维超声心动图评价心肌梗死与扩张型心肌病患者左心室功能的研究  

Evaluation of left ventricular volume and function in patients with myocardium infarction and dilated cardiomyopathy by real-time three-dimensional echocardiography

作　　者：姜志荣[1] 张小龙 李大海[2] 常洪仿[1] 

机构地区：[1]青岛大学医学院附属医院心脏超声科,山东省青岛市266003 [2]河北大学附属医院超声科

出　　处：《临床超声医学杂志》2008年第11期744-747,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨实时三维超声心动图(RT-3DE)评价心肌梗死(MI)和扩张型心肌病(DCM)患者左心室功能的可行性及价值。方法应用RT-3DE系统三维圆盘总和法分别测量26例MI组患者、10例DCM组患者及20例正常人(对照组)的左室舒张末期容积(LVEDV)、收缩末期容积(LVESV)和左室射血分数(LVEF),并与二维超声心动图(2-DE)双平面Simpson法和M型超声心动图(ME)Teichholz法的测值比较。结果①MI组、DCM组2-DE的LVEDV、LVESV测值低于RT-3DE;②MI组、DCM组ME的LVEDV、LVESV、LVEF测值高于RT-3DE;③RT-3DE、2-DE、ME显示MI组、DCM组患者LVEDV、LVESV均大于对照组,LVEF低于对照组,尤以DCM组为著。④对照组、MI组及DCM组RT-3DE与2-DE的LVEF测值高度相关;⑤对照组、MI组及DCM组RT-3DE与ME的LVEF测值高度相关。结论RT-3DE能显示心腔立体结构,较客观反映MI及DCM患者左心室功能的变化。Objective To assess the accuracy and value of real - time three - dimensional echocardiography（RT- 3DE） for quantifying the left ventricular（LV）volumes and ejection fraction in patients with myocardium infarction and dilated cardiomyopathy. Methods Thirty - six patients were divided into two groups： Group MI included 26 patients with myocardial infarction; Group DCM were consisted of 10 patients with dilated cardiomyopathy, and 20 healthy subjects with normal LV geometry and wall motion were enlisted as control group. The LV end diastolic volume （LVEDV）,LV end systolic volume（LVESV） and LV ejection fraction were measured by 3DQ - Qlab analysis software offline using MOD method . Then the results were compared with those measured by 2 - DE using modified Simpson method and M - Teiehholz method. Results In MI,DCM groups, the results of LVEDV,LVESV obtained by 2 - DE were significantly lower than that of RT- 3DE. In MI,DCM groups, the results of LVEDV, LVESV, LVEF obtained by ME were significantly higher than that of RT- 3DE. In control group,there was no difference among RT- 3DE,2- DE and ME for LV volume and EF measurement（ P 〉 0.05）. The results of LVEF obtained by RT- 3D showed good correlation with 2 - DE in control,MI,DCM groups. The measurement of LVEF obtained by RT- 3D showed good correlation with M- mode in control ,MI,and DCM group. Conclusion RT - 3DE can accurately display heart stereochemieal structure, and can objectively reflect the LVF changes of patients with MI and DCM.

关 键 词：超声心动描记术 三维 心肌梗死 扩张型心肌病 心室功能 左 

分 类 号：R540.45[医药卫生—心血管疾病] R542.2[医药卫生—内科学]