组织多普勒对急性冠状动脉综合征患者左室舒张功能的评价作用  

Evaluation of left ventricular diastolic function in patients with acute coronary syndrome by Doppler tissue imaging

作　　者：郭荣[1] 李沅敏[1] 孙辉[1] 吴家康[1] 刘伟静[1] 徐亚伟[1] 

机构地区：[1]同济大学附属第十人民医院心内科,上海200072

出　　处：《同济大学学报（医学版）》2012年第4期49-53,共5页Journal of Tongji University(Medical Science)

摘　　要：目的应用组织多普勒成像技术,评价急性冠状动脉综合征(acute coronary syndrome,ACS)患者的左室舒张功能。方法入选275例ACS患者和50名健康对照者,记录常规超声心动图及二尖瓣血流频谱资料,并在二尖瓣瓣环水平处,测量舒张早期充盈速度(E)和舒张晚期充盈速度(A),测定E/A比值。将上述资料进行比较并对患者进行随访。结果 ACS组左室舒张功能较对照组显著下降,STEMI组较NSTEMI组左室舒张功能有所下降。DTI较二尖瓣血流频谱对左室舒张功能不全的阳性率更高。Kaplan-Meier生存分析显示舒张功能不全患者更易出现心血管事件。结论急性冠脉综合征患者存在不同程度的舒张功能不全,DTI能很好地评价左室舒张功能,对临床预后判定也有一定的价值。Objective To evaluate the left ventricular diastolic function in patients with acute coronary syndrome （ACS） by Doppler tissue imaging （DTI）. Methods Two hundred and seventy five patients with ACS （ACS group ） and 50 healthy subjects （control group ） were included in the study. The Doppler echocardiography was performed and mitral inflow data were recorded. The peak early filling velocity （E）, peak filling velocity at atrial contraction （A） and E/A ratio were measured and compared between two groups. Results Left ventricular diastolic function was significantly decreased in ACS group （P 〈0.010）. The measurement of DTI at the septal side was not significantly different from that at LV wall in all group （ P 〉 0.05 ）. Compared with mitral inflow by chi-square test, the positive rate of DTI was higher （P 〈 0.01 ）. The consistency between two methods was not strong （ Kappa = 0.552）. Conclusion Patients with ACS have varying degrees of diastolic dysfunction. The assessment by DTI is useful for evaluating diastolic function, especially in detecting pseudonormalization pattern of mitral inflow.

关 键 词：急性冠状动脉综合征 超声心动图 组织多普勒 诊断 

分 类 号：R541.4[医药卫生—心血管疾病]