RT3DE评估严重冠心病患者LVEF与同步性关系的临床研究  

Clinical study of RT3DE in assessment of the relations between LVEF and contractive synchro- nism in patients with severe coronary artery disease

作　　者：边晓琳[1] 张连仲[2] 王雁[1] 

机构地区：[1]河南省肿瘤医院超声科,郑州450008 [2]河南省人民医院超声科

出　　处：《中国实用医刊》2012年第17期41-43,共3页Chinese Journal of Practical Medicine

摘　　要：目的运用实时三维超声心动图（RT3DE）研究冠心病三支冠状动脉病变患者左室收缩功能（LVEF）与同步性的关系。方法应用实时三维超声心动图将40例经选择性冠状动脉造影证实的三支冠状动脉病变患者分为陈旧性心肌梗死组（OMI，n=20）和非心肌梗死组（nMI，n=20），对其左室舒张末期容积（LV-EDV）、左室射血分数（LVEF）、16节段达峰时间标准差（Tmsv16-SD）及其最大差值（Tmsv16-Dif）进行研究，并与20例正常人进行比较。结果与对照组相比，冠心病患者LVEDV、Tmsv16-SD、Tmsv16-Dif增加，LVEF降低，差异均有统计学意义（P〈0．01）；与非心肌梗死组对比，OMI组LVEDV、Tmsv16-SD、Tmsv16-Dif增加，LVEF降低，差异有统计学意义（P〈0．01）；冠心痛患者Tmsv16-SD、Tmsv16-Dif与LVEF显著负相关（分别为r=-0．594，r=-0．498，P〈0．01）。结论冠心病三支病变引起左心室重构，陈旧性心肌梗死左心室重构甚重于非心肌梗死患者；冠心病左室收缩同步性指标一定程度上能够反映左室收缩功能。Objective To study the relations between left ventrieular ejection fraction （LVEF） and contractive synchronism in patients with three-vessels coronary artery disease by real-time three-di-mensional echocardiography （ RT3DE ）. Methods Forty patients with three-vessel disease coronary artery disease （CAD） and 20patients without CAD confirmed by selective coronary angiography were choosed. CAD patients were di- vided into old myocardial infarction group （OMI, n = 20） and non -myocardial infarction group （nMI, n = 20）. The left ventricle end-diastole volume（ LVEDV）, ejection fraction （LVEF）, the 16 segments and those standard deviation （Tmsv16-SD）, the maximal difference of time among all 16 segments （Tmsv16-Dif） were measured by RT3DE. Results Compared with control group： LVEDV, Tmsv16-SD and Tmsv16-Dif were significantly increased, LVEF was significantly decreased in CAD patients （P 〈 0.01 ）. Compared with nMI group, the same change happened in OMI group （P 〈 0.05）. In CAD pa- tients group, LVEF was negatively correlated with Tmsv16-SD （r = - 0. 594 ,P 〈 0.01 ）and Tmsv16-Dif （r = -0. 498,P 〈 0.01 ）. Conclusions Left ventricular remodeling is resulted in three-vessel disease. The left ventricular remodeling in OMI outweights nMI. Left ventricular contractive synchronism index can reflect left ventricular systolic function in certain degree.

关 键 词：冠心病 实时三维超声心动图 左心室 收缩功能 同步性 

分 类 号：R541[医药卫生—心血管疾病]