实时三维超声心动图评价肺高压患者左心室容积和功能  被引量:1

Assessment of left ventricular function of pulmonary hypertension patients by real-time three dimensional echocardiography

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作  者:杨军[1] 白洋[1] 赵斓婷[1] 王玥[1] 郭洁[1] 

机构地区:[1]中国医科大学附属第一医院心血管超声科,沈阳110001

出  处:《中华超声影像学杂志》2012年第8期670-674,共5页Chinese Journal of Ultrasonography

基  金:辽宁省自然科学基金(2009213);高等学校博士学科点专项科研基金(20112104110010)

摘  要:目的应用单心动周期实时三维超声心动图(sRT-3DE)与二维超声(2DE)对比研究肺高压(PH)患者左室容积及功能的变化,分析PH患者左室改变的影响因素。方法临床诊断为PH,经超声-fi,动图评估肺动脉收缩压(PASP)≥40mmHg,排除存在左心疾病及先天性体肺分流的30例患者为PH组,正常体检人群30例为对照组,行常规2DE及sRT-3DE检查,脱机工作站分析,获得左、右室相关2DE及sRT-3DE参数。结果①PH组二维和三维左室射血分数(LVEF)差异有统计学意义(P〈O.01),2DE与sRT-3DE参数的一致性较对照组差。②PH组左室舒张、收缩末容积(LVEDV、LVESV)及每搏量(LVSV)较对照组减小(P〈0.01),三维LVEF较对照组减小(P〈O.05),二维LVEF变化无统计学意义,左室收缩、舒张末球形指数(Sis、SId)、偏心指数(EId、EIs)显著大于对照组(P〈0.01)。③PH组LVEDV与PASP负相关(r=-0.47),与右室每搏量(RVSV)及射血分数(RVEF)正相关(r分别为0.84、0.66),与右室舒张末容积(RVEDV)无显著相关;LVEF与PASP负相关(r=-0.54),与RVSV、RVEF正相关(r分别为0.58、0.53),与RVEDV无显著相关;LVEDV与SId、Sis负相关(r分别为一0.65、-0.61),与EId、EIs负相关(r分别为-0.67、-0.67);LVEF与SId、Sis负相关(r分别为-0.64、-0.61),与EId、EIs负相关(r分别为-0.66、-0.68),以上r值均P〈O.01。结论PH导致左室容积减小,收缩功能减低,其变化与RVSV和RVEF减低、PASP增高程度及sI和EI增加有关。sRT-3DE可以为PH患者提供准确的左室容积和功能信息。Objective To assess the changes of left ventricule and analyze the influential factors in pulmonary hypertension (PH) by comparing the changes of left ventricular volume and function using single cardiac cycle real-time three dimensional echocardiography ( sRT-3DE ) and two-dimensional eehocardiography (2DE). Methods In case group, there were 30 inpatients diagnosed as PH, systolic pulmonary artery pressure(PASP)≥40 mmHg estimated by echocardiography,excluding left heart disease or congenital systemic-pulmonary circulation shunt. There were 30 healthy people as control group. Conventional 2DE and sRT-3DE were performed in both groups and obtained 2D and 3D parameters. Results ①In case group, the 2D-LVEF were significantly larger than 3D-LVEF (P 〈 0.01 ). There was less agreement of 2DE and 3DE in ease group than in control. ② Comparing with the control group, left ventricular EDV,ESV and SV in case group decreased ( P 〈0.0l) ,so as to 3D-LVEF ( P G0.05). The left ventricular spherical index(Sis, SId)and eccentric index (EId, EIs ) in case group were significantly larger than those in control group ( P 〈0.01). ③LVEDV in case group was negatively correlated with PASP (r= - 0.47) ,and positively correlated with RVSV and RVEF ( r = 0.84,0, 66) ; 3D-LVEF in case group was negatively correlated with PASP ( r = - 0.54) ,and positively correlated with RVSV and RVEF ( r = 0.58, 0.53) ;there was no significant correlation between LVEDV and RVEDV. LVEDV was negatively correlated with Sis and SId ( r = -0.65, -0.61),so as to EId and EIs ( r = -0.67,0.67). LVEF was negatively correlated with Sis and SId ( r = - 0.64, - 0.61),so as to EId and EIs ( r = - 0.66, - 0.68), and the corresponding P all above were less than 0. 01. Conclusions PH can result in reductions of left ventricular volume and systolic function,and the variations of which have the correlations with the severity of PH and the increase in SI and EI. sRT-3DE can provide a method

关 键 词:超声心动描记术 实时三维 高血压 肺性 心室功能  

分 类 号:R445.1[医药卫生—影像医学与核医学]

 

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