实时三维超声评价左室室壁瘤外科治疗后左心室局部收缩功能的改变  

Real-time Three-dimensional Echocardiography Evaluation in Changes of Left Ventricular Regional Systolic Function after Surgical Treatment of Left Ventricular Aneurysm

作　　者：李浩杰[1] 宋云虎[1] 胡盛寿[1] 孙寒松[1] 许建屏[1] 王巍[1] 王水云[1] 凤玮[1] 段福建[1] 叶赞凯[1] 

机构地区：[1]北京协和医学院中国医学科学院北京阜外心血管病医院心血管病研究所心脏外科,北京100037

出　　处：《中国胸心血管外科临床杂志》2011年第3期209-213,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的利用实时三维超声(real-time three-dimensional echocardiography,RT-3DE)评估左心室室壁瘤(LVA)外科治疗后左心室局部收缩功能的改变。方法 2009年2月至2010年2月,北京阜外心血管病医院连续14例冠状动脉粥样硬化性心脏病合并左心室室壁瘤形成患者(LVA组)接受手术治疗。LVA组患者术前和术后4个月随访期间均行二维超声(2DE)、RT-3DE,通过Qlab软件分析计算获得左心室局部射血分数(EF);同时测量12例正常人的左心室局部EF作为正常对照(对照组)。利用统计方法对比分析LVA组(术前、术后4个月)与对照组左心室局部EF。结果 LVA组患者术前左心室局部EF呈心尖部至基底部递增方向,与对照组方向相反;除下基底段、下侧基底段和前侧基底段外,其余14个节段较对照组显著降低(P<0.05)。术后4个月左心室局部EF恢复从基底部至心尖部的方向递增,前基底段和侧壁节段的EF与对照组差异无统计学意义(P>0.05),其余节段的EF低于对照组(P<0.05)。结论 RT-3DE是评估LVA患者左心室局部收缩功能的有效检查方法。LVA患者手术治疗后早期左心室局部收缩功能恢复正常递增方向,部分非室壁瘤节段收缩功能恢复。Objective To investigate changes of left ventricular regional systolic function after surgical treatment of left ventricular aneurysm（LVA） by real-time three-dimensional echocardiography（RT-3DE）.Methods From February 2009 to February 2010,14 consecutive patients who were diagnosed to have coronary artery diseases with LVA underwent surgical repair and coronary artery bypass grafting（LVA group） in our hospital.All patients of the LVA group were followed up for a mean period of 4 months.Two-dimensional echocardiography（2DE） and RT-3DE were performed before operation and during the follow-up.Left ventricular regional ejection fraction（EF） was acquired by Qlab software analysis.At the same time,12 healthy persons were included as controls（control group）.Statistical analyses were carried out to compare left ventricular regional EF between the LVA group（before operation and 4 months after operation） and the control group.Results Contrary to the control group,preoperative regional EF of the LVA group increased from apex to base.In addition to the inferior basal segment,lateral-inferior basal segment and anterior-inferior basal segment,regional EF in the remaining 14 segments were significantly lower than that of the control group（P0.05）.At postoperative follow-up,regional EF recovered the increase from base to apex,and there was no significant difference between anterior-inferior segment and lateral segment regional EF of the LVA group and those of the control group（P0.05）,while regional EF of other segments in the LVA group was lower than that in the control group（P0.05）.Conclusion RT-3DE is an effective method to assess left ventricular regional systolic function in patients with LVA.After LVA repair and coronary artery bypass grafting,regional systolic function will restore to the normal direction of progressive increase,and some non-aneurysm segments systolic function will go back to normal.

关 键 词：左心室室壁瘤 实时三维超声 局部收缩功能 局部射血分数 

分 类 号：R654.2[医药卫生—外科学]