实时三维超声心动图评价风湿性心脏瓣膜病瓣膜置换术前术后右心室功能的临床研究  

Pre-and post-operative assessment of the right ventricular function of rheumatic heart disease with real-time three-dimensional echocardiography

作　　者：解翔[1] 姜凡[1] 张新书[1] 陈万林[1] 杨凤[1] 

机构地区：[1]安徽医科大学第二附属医院超声诊断科,合肥230601

出　　处：《安徽医学》2011年第4期420-422,共3页Anhui Medical Journal

基　　金：安徽医科大学中青年教师科研基金(编号:2010XKJ104)

摘　　要：目的应用实时三维超声心动图评价风湿性心脏瓣膜病瓣膜置换术前、后右心功能的变化,探讨其临床价值。方法应用GE VIVID 7.0采集30例风湿性心脏瓣膜病患者瓣膜置换术前及术后右室全容积图像。适用Tom Tec 4D RV-analysis软件,结合半自动心内膜探测系统获取右室舒张末容积(RVEDV)、收缩末容积(RVESV)、搏出量(SV)、射血分数(RVEF)及右室整体时间-容积曲线。并用配对t检验及直线相关分析进行对比研究手术前后右室功能的变化。结果术前RVEDV、RVESV、RVEF与术后差异均有统计学意义(P<0.05)。术后RVEDV、RVESV较术前有明显减小,以RVESV减少最为显著,RVEF明显增加(P<0.05)。相关分析显示:RVEDV手术前后相关性高于RVESV(r=0.799,P<0.0001),提示术前右心功能不全主要与舒张末容积增大有关。结论实时三维超声心动图能够精确量化右心室功能,为临床正确判断风湿性心脏瓣膜病瓣膜置换前后右心室功能、观察疗效、判断预后等提供可靠的客观依据。Objective To compare the pre-and post-operative right ventricular functions of rheumatic heart disease with real-time three-dimensional echocardiography.Methods Thirty patients with rheumatic heart disease,the pre-and post-operative right ventricular of the full volume images were performed by using GE ViVid 7.0 with X3-1 probe.The right ventricular global time-volume curve and end-diastolic volume（RVEDV）,end-systolic volume（RVESV）,ejection fraction（RVEF） were obtained by the off-line Tom Tec software 4D LV-Analysis system and primary manual tracking with semiautomated border detection.The outcomes were assessed with paired t-test and pearson correlation coefficient analysis.Results Compared with pre-operative right ventricular end-diastolic and end-systolic volumes,stroke volume,ejection fraction;post-operative right vetricular end-diastolic and end-systolic volumes obviously decreased after surgical valve replation（P0.05）.Accordingly,compared with pre-operative stroke volume,ejection fraction,post-operative markedly increased（P0.05）.Correltions of the pre-and post-operative right ventricular end-diastolic volume were higher than those of the pre-and post-operative right ventricular end-systolic volume（r=0.799,P0.0001）.The results indicated that per-operative right ventricular funtion correlation with the right ventricular end-diastolic volume.Conclusion RT-3DE can provide quantitative information of cardiac function for pre-and post-operative follwing-up Valve replation of Rheumatic heart disease.

关 键 词：实时三维超声心动图 风湿性心脏瓣膜病 右心功能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R654.2[医药卫生—诊断学]