实时三维超声心动图与组织多普勒评价扩张型心肌病患者左心室整体收缩功能的对比研究  

Comparative study on left ventricular systolic function by real-time three-dimensional echocardiography and tissue Doppler imaging index in dilated cardiomyopathy patients

作　　者：鲁力[1] 郭瑞强[1] 郝力丹[1] 陈金玲[1] 李丽[1] 

机构地区：[1]武汉大学人民医院超声影像科,湖北武汉430060

出　　处：《生物医学工程与临床》2011年第3期223-225,F0002,共4页Biomedical Engineering and Clinical Medicine

摘　　要：目的 对比实时三维超声心动图（RT-3DE）与组织多普勒（TDI）评价扩张型心肌病（DCM）患者的左心室收缩功能的临床意义.方法 对临床及超声心动图确诊为DCM患者33例,其中男性20例,女性13例;年龄45～69岁,平均年龄53岁;符合1996年世界卫生组织（WHO）对DCM的诊断标准,均为窦性心律,纽约心脏学会（NYHA）分级Ⅱ～Ⅳ级.健康对照组28例,其中男性16例,女性12例;年龄43～64岁.平均年龄51岁;体格榆查、心电图及超声心动图证实无心血管疚病,均为窦性心律.分别行二维超声心动图（2DE）、RT-3DE及TDI 扫查,测量并计算各参数,以28例健康体检者作为对照.结果 DCM患者左心室射血分数（LVEF Simpson与LVEF RT-3DE）、Sm明显减低,Tei指数增大,与对照组相比,差异均存在显著统计学意义（P＜0.01）.对照组中,LVEF RT-3DE、Tei指数及Sm与LVEF Simpson有显著相关性（分别为r=0.895,P＜0.01;r=0.629,P＜0.05;r=-0.760,P＜0.05）,在DCM患者中,LVEF RT-3DE与LVEF Simpson相关性仍然显著（r=0.818,P＜0.01）,LVEF RT-3DE与Tei指数及Sm的相关性较对照组要明显减低（分别为r=0.487,P＜0.05;r=-0.493,P＜0.05）.结论 RT-3DE较Sm、Tei指数更能有效评价DCM患者左心窒收缩功能,为临床提供有价值的信息.Objective To compare the real-time three-dimensional echocardiography（RT-3DE） and tissue Doppler imaging（FDI） in patients with dilated cardiomyopathy（DCM）. Methods Thirty-three DCM patients with diagnostic code of the WHO in 1996（20 males and 13 females, aged 45 - 69 years old, mean age 53 years old, NYHA Ⅱ - Ⅳ） and 28 healthy volunteers（16 males and 12 females, aged 43 - 64 years old, mean age 51 years old） were enrolled. All the healthy volunteers were confirmed by necessary clinical evaluation. Two-dimensional echocardiography （2DE）, RT- 3DE and the TDI were employed for the evaluation of the patients. Results The left ventricular ejection fraction（LVEF） indexes（LVEFSimpson and LVEFRT-3DE） and myocardial systolic（Sm） of the DCM patients were decreased, whereas the Tei index was increased, which were significantly different from that in the healthy volunteers（P 〈 0.001）. In the control group, the LVEFSimpson was significantly related to the other methods： LVEFRT-3DE （r = 0.895 ,P 〈 0.01）, Sm （r = 0.601, P 〈 0.05） and Tei index （r = - 0.513, P〈 0.05）. In the DCM group, LVEFSimpson was also significantly related to LVEFRT-3DE（r = 0.818, P〈 0.01）, but was less significantly related to Sm（r = 0.487, P〈 0.05） and Tei index（r = - 0. 493, P〈 0.05）, as compared with that in the control group. Conclusion It is demonstrated that as compared with Sm and Tei index, RT-3DE is a simple, rapid and helpful index for evaluating the left ventricular systolic function in DCM patients and would provide valuable information in clinical practice.

关 键 词：实时三维超声 二尖瓣环位移 TEI指数 扩张型心肌病 收缩功能 左心室 

分 类 号：R542.2[医药卫生—心血管疾病]