超声心动图评价扩张型心肌病患者左心房功能及其临床意义  

Evaluation of left atrial function in patients with dilated cardiomyopathy by echocardiography

作　　者：吴田[1] 郭瑞强[1] 陈金玲[1] 周青[1] 

机构地区：[1]武汉大学人民医院超声影像科,430060

出　　处：《中华超声影像学杂志》2011年第10期842-845,共4页Chinese Journal of Ultrasonography

摘　　要：目的 探讨超声心动图评价扩张型心肌病（DCM）患者左心房功能的临床意义.方法 DCM患者31例,健康体检者30例.常规测量左室内径、左房内径、二尖瓣舒张期E、A峰,计算E/A值；Simpson＇s法测量左室射血分数（LVEF）.分别采集各受试者的心尖二腔、四腔和心尖左室长轴观动态组织速度图像,将取样点分别置于左房前壁、后壁、下壁、侧壁和房间隔中间部获得应变率曲线,测量收缩期左房峰值应变率（LASRs）、舒张早期左房峰值应变率（LASRe）和舒张晚期左房峰值应变率（LASRa）,计算五个位点3个心动周期的平均值（mLASRs、mLASRe和mLASRa）.结果 与对照组比较,DCM组左房内径及左室内径均较对照组显著增大（P ＜0.01）;DCM组E/A值与对照组的差异无统计学意义（P＞0.05）;DCM组LVEF和左房缩短分数（LAFS）较对照组显著降低（P＜0.01）;DCM组mLASRs、mLASRe和mLASRa均较对照组减低,差异均有统计学意义（P＜0.05）.DCM组的mLASRa与LAFS呈显著正相关（r =0.79,P＜0.01）.结论 DCM患者左房储蓄、管道和辅泵功能均减低,超声心动图可以定量评价DCM患者左房功能.Objective To evaluate left atrial function in patients with dilated cardiomyopathy （DCM）by echocardiography.Methods There were 31 patients with DCM and 30 controls in this study.Left atrial diameter （LAD）,left ventricular diameter （LVD） were measured by M-mode in parasternal long-axis view.Mitral flow parameters including peak velocities during early diastole （E） and late diastole （A） were measured by pulsed-wave Doppler echocardiography,and the E/A ratio was calculated.Left ventricular ejection fraction （LVEF） was measured with Simpson′s method on the 2-chamber （Ap2c） and 4-chamber （Ap4c） views.Strain rate （SR） imaging was performed on all cases.Peak SR was measured at each segment （septal,lateral,posterior,anterior,and inferior walls） and mean peak systolic left atrial SR （mLASRs）,mean peak early diastolic left atrial SR （mLASRe） and mean peak atrial systolic left atrial SR （mLASRa） were calculated by averaging the data in all segments.Results Compared with controls,LAD and LVD were significantly increased （ P 〈0.01 ）,the E/A ratio had no significant changes （ P 〉0.05）.LVEF and left atrial fractional shortening （LAFS） turned lower,mLASRs,mLASRe,and mLASRa of DCM decreased significantly （ P 〈 0.05）.mLASRa of DCM correlated positively with LAFS （ r =0.79,P 〈 0.01 ）.Conclusions The left atrial function of DCM decreased,including the reservoir,conduit and pump function.Echocardiography could evaluate the left atrial function of DCM quantitatively.

关 键 词：超声心动描记术 心肌病 扩张型 心房功能 左 

分 类 号：R445.1[医药卫生—影像医学与核医学] R542.2[医药卫生—诊断学]