实时三维超声心动图评价儿童左室心肌收缩同步性的研究  

Real-Time Three-Dimensional Echocardiographic Assessment of Left Ventricular Asynchrony in Pediatrics

作　　者：徐兆峰[1] 齐悦[1] 贡欣[1] 常亚彬[1] 张宏艳[2] 

机构地区：[1]天津市儿童医院超声心动图室,300074 [2]天津市儿童医院心脏内科,300074

出　　处：《天津医药》2011年第11期1013-1015,共3页Tianjin Medical Journal

基　　金：天津市卫生局科技基金资助项目(项目编号:06KZ11)

摘　　要：目的:研究实时三维超声心动图在评价儿童左室心肌收缩同步性中的应用价值。方法:应用实时三维超声心动图检测55例正常儿童(对照组)、10例扩张型心肌病(DCM)儿童及22例川崎病(KD)儿童,测量左室16节段心肌达最低收缩末期容量时间的最大差异(Tmsv16-Dif)及其标准差(Tmsv16-SD),为排除心率的影响,将上述2项指标与心率比值的百分数(Tmsv16-Dif%,Tmsv16-SD%)做为其标准化值进行比较研究。结果:对照组中Tmsv16-Dif、Tmsv16-SD、Tmsv16-Dif%及Tmsv16-SD%接近正态分布,且不同性别间差异无统计学意义;不同年龄组间Tmsv16-Dif、Tmsv16-SD差异有统计学意义;而Tmsv16-Dif%、Tmsv16-SD%差异无统计学意义。KD与DCM组Tmsv16-Dif、Tmsv16-SD、Tmsv16-Dif%及Tmsv16-SD%均高于对照组。Tmsv16-Dif、Tmsv16-SD、Tmsv16-Dif%及Tmsv16-SD%均与LVEF存在负相关(r分别为-0.583、-0.565、-0.487、-0.567,均P<0.01)。对照组的左室16段心肌容量—时间曲线排列有序,呈抛物线状,起伏较为一致,各节段心肌收缩达峰时间几乎一致;KD及DCM患儿左室16节段心肌容量—时间曲线排列紊乱,达峰时间点分散。结论:可利用Tmsv16-Dif%及Tmsv16-SD%作为评价不同年龄儿童左室收缩同步性的指标。Objective：To investigate the clinical value of real-time three-dimensional echocardiography （RT3DE） in assessment of left ventricular systolic asynchrony in children.Methods：RT3DE was used to detect 55 normal children （control group）,10 children with dilated cardiomyopathy （DCM group） and 22 children with Kawasaki disease （KD group）.The 16-segment myocardial systolic volume reached the lowest maximal difference （Tmsv16-Dif） and the standard deviation （Tmsv16-SD） were measured.Values of Tmsv16-Dif and Tmsv16-SD were expressed as the percentage of the duration of the cardiac cycle （Tmsv16-Dif%,Tmsv16-SD%） to compare patients with significantly different heart rate.Results：In control group,there were no significant differences in Tmsv16-Dif,Tmsv16-SD,Tmsv16-Dif% and Tmsv16-SD% between male and female patients.There were a significant differences in Tmsv16-Dif and Tmsv16-SD between different age groups,but no significant differences in Tmsv16-Dif% and Tmsv16-SD% between different age groups.The values of Tmsv16-Dif,Tmsv16-SD,Tmsv16-Dif% and Tmsv16-SD% were significantly higher in KD and DCM groups than those of control.The values of Tmsv16-Dif,Tmsv16-SD,Tmsv16-Dif% and Tmsv16-SD% were negatively correlated with the left ventricular ejection fraction （LVEF） （r=-0.583,-0.565,-0.487 and-0.567,P 0.01）.In control group,the RT3DE segmental time-volume curves showed in order,but they were disorder and the peak time-point spread in KD and DCM groups.Conclusion：Tmsv16-Dif% and Tmsv16-SD% of RT3DE can quantify global left ventricular mechanical dyssynchrony.RT3DE is a feasible and accurate method for analysis of left ventricular function.

关 键 词：超声心动描记术 三维 心肌病 扩张型 黏膜皮肤淋巴结综合征 心室功能 左 

分 类 号：R540.45[医药卫生—心血管疾病]