实时三维超声心动图对冠心病心肌梗死后左室重构评价的初步研究  

The Initial Study of Real-time Three-dimensional Echocardiography in Evaluating of Left Ventricular Remodeling after Myocardial Infarction

作　　者：陈敏华[1] 郭盛兰[2] 覃诗耘[2] 计慧敏[2] 邓燕[1] 吴棘[1] 黄莺[2] 

机构地区：[1]广西医科大学第一附属医院超声科,南宁市530021 [2]广西医科大学

出　　处：《中国超声医学杂志》2009年第5期478-481,共4页Chinese Journal of Ultrasound in Medicine

基　　金：广西科学基金资助项目（No.桂科基0575061）

摘　　要：目的探讨实时三维超声心动图（RT-3DE）对冠心病心肌梗死（心梗）后左室重构的评价。方法对30例冠心病心梗后左室重构患者及30例正常对照组,分别应用M型（MME）、二维超声心动图（2DE）及RT-3DE测量左室舒张末期容积（LVEDV）、左室收缩末期容积（LVESV）、左室射血分数（LVEF）、左室心肌质量（LVM）、左室重构指数（LVRI）。分析组间及组内的差异,并用左室重构患者测值与Gensini评分进行相关性分析。结果（1）左室重构组左室容积、LVM较正常对照组增加,而LVEF、LVRI减小;（2）RT-3DE在正常对照组中与MME及2DE测值差异无统计学意义（P〉0.05）,而在重构组中与MME、2DE测值差异存在统计学意义（P〈0.05）;（3）RT-3DE测量的LVEDV、LVESV、LVEF及LVRI与Gensini积分有较好的相关性（r=0.844,0.880,-0.839,-0.854）,而LVM与Gensini积分无显著相关性（r=0.431）;（4）RT-3DE能直观地显示冠心病心梗后左室形态的不规则改变。结论应用RT-3DE可较好地评价冠心病心梗后左室大小形态的重构及功能重构,其测量的LVRI可定量评价其不规则重构的程度。Objective To study the value of real-time three-dimensional echocardiography （RT-3DE） in evaluating the left ventricular remodeling （LVR） after myocardial infarction （MI） . Methods Thirty patients with LVR and thirty healthy volunteers underwent M-mode echocardiography （MME）, two dimensional echocardiography （2DE） and RT 3DE to obtain left ventricular （LV） end-diastolic volume （LVEDV）, LV end-systolic volume （LVESV）, LV ejection fraction （LVEF）, LV mass （LVM）, LV remodeling index （LVRI） . Comparing the difference among and in the groups, and evaluated the correlations between the value of LVR patients and Gensini score. Results （1） Comparing to the healthy volunteers, LVEDV, LVESV, LVM in LVR patients were significantly greater （P〈0.05） and the LVEF, LVRI were less （P〈0.05） . （2） There was significant difference in LVR patients among the value obtained from RT3DE and MME, 2DE （P〈0.05）, but there was no significant difference in healthy group. （3） There were well correlation between LVEDV, LVESV, LVEF, LVRI obtained from RT-3DE and Gensini score （r=0. 844, 0. 880,-0. 839, -0. 854）, but there wasn＇t significant correlation between LVM and Gensini score （r=0. 431） . （4） RT 3DE could show the irregularity change of LV shape after MI graphically and directly. Conclusions It had advantage of using RT 3DE to evaluate LVR after MI, the LVRI obtained by RT-3DE could quantitatively evaluate the LV irregularity change after MI.

关 键 词：实时三维超声心动图 冠心病 左室重构 左室重构指数 

分 类 号：R540.45[医药卫生—心血管疾病] R259.414[医药卫生—内科学]