二维超声与定量组织多普勒技术观察缩窄性心包炎患者心包与心肌运动  

Observation of the motion of pericardium and myocardium in constrictive pericarditis using two-dimensional echocardiography and quantitative tissue Doppler imaging

作　　者：卢晓芳[1] 王新房[1] 谢明星[1] 吕清[1] 王静[1] 贺林[1] 杨亚利[1] 

机构地区：[1]华中科技大学协和医院超声影像科,武汉430022

出　　处：《临床心血管病杂志》2010年第12期890-893,共4页Journal of Clinical Cardiology

摘　　要：目的:用二维超声与定量组织多普勒技术观察心包和心肌的运动,评价其在缩窄性心包炎诊断中的价值。方法:二维超声分别观察25例正常人、22例缩窄性心包炎患者左室后壁和下壁壁层心包与心肌(包括外层心肌和内层心肌)在心动周期中的运动及差异,应用定量组织多普勒成像技术测量壁层心包、外层心肌和内层心肌收缩期峰值位移(D1、D2和D3),分别计算外层心肌与壁层心包、内层心肌与外层心肌收缩期峰值位移的比值(D2/D1、D3/D2)。结果:常规二维超声显示正常组外层心肌的运动幅度高于壁层心包,而内层心肌和外层心肌运动基本一致;缩窄性心包炎由于心包脏壁两层粘连,导致外层心肌运动受限,与壁层心包接近,而内层心肌的运动幅度高于外层心肌。正常组外层心肌与壁层心包的收缩期峰值位移之比(D2/D1)高于缩窄性心包炎组,差异有统计学意义[(2.03±0.42)和(1.48±0.53),P<0.05];而缩窄性心包炎组内层心肌与外层心肌收缩期峰值位移的比值(D3/D2)高于正常组,差异亦有统计学意义[(2.16±0.30)和(1.23±0.29),P<0.05]。结论:应用二维超声结合定量组织多普勒成像技术观察心包与心肌在心脏收缩期的动态变化,发现缩窄性心包炎患者和正常人有明显差异,可为缩窄心包炎的诊断提供新的依据。Objective：To observe the motion of pericardium and myocardium using two-dimensional echocardiography and quantitative tissue Doppler imaging,and to investigate its value in the diagnosis of constrictive pericarditis （CP）.Method：The motion of pericardium and myocardium and the difference between them were investigated using two-dimensional echocardiography and quantitative tissue Doppler imaging technique in 25 normal persons and 22 patients with CP,systolic peak displacements of pericardium,outer-layer and inner-layer of myocardium （D1,D2,D3） were measured respectively from quantitative tissue displacement curves,then the ratio of D2/D1 and D3/D2 were calculated.Result：Two-dimensional echocardiography showed the motion of outer-layer of myocardium was stronger than that of pericardium in normal persons,and motions of outer-layer and inner-layer of myocardium were almost the same.However,the motion of outer-layer of myocardium was closer to that of pericardium in patients with CP,probably because of adhesion of pericardium,and the motion of inner-layer of myocardium was stronger than that of outer-layer of myocardium.The ratios of D2/D1 were higher in normal persons than those in patients with CP （2.03±0.42 vs 1.48±0.53,P0.05）; while the ratios of D3/D2 were higher in patients with CP than those in normal persons （2.16±0.30 vs 1.23±0.29,P0.05）.Conclusion：Obvious differences exist in the motion of pericardium and myocardium between normal persons and patients with CP,observation of these differences using two-dimensional echocardiography and quantitative Doppler tissue imaging will provide new proof in the diagnosis of CP.

关 键 词：缩窄性心包炎 二维超声 定量组织多普勒成像 心包 心肌 

分 类 号：R542.1[医药卫生—心血管疾病]