实时三维超声心动图和组织多普勒评价扩张型心肌病左心室舒张早期同步性的相关性研究  

Comparison of real-time three-dimensional echocardiography and tissue Doppler imaging in assessing left ventricular diastolic synchrony

作　　者：叶雪存[1] 陈慧倩[1] 王卫真[1] 崔亮[1] 

机构地区：[1]江西省人民医院超声科,江西南昌330006

出　　处：《生物医学工程与临床》2012年第5期450-453,共4页Biomedical Engineering and Clinical Medicine

摘　　要：目的比较实时三维超声心动图和组织多普勒显像在分析正常人和扩张型心肌病（DCM）患者的左心室舒张早期同步性的临床价值。方法选取37例DCM患者（DCM组）,其中男性25例,女性12例;年龄46-87岁,平均年龄65.4岁（标准差10.0岁）。健康志愿者27例（对照组）,其中男性19例,女性8例;年龄50-72岁,平均年龄60.3岁（标准差9.7岁）。同时进行实时三维超声心动图和组织多普勒检查,测定舒张早期二尖瓣频谱峰值与二尖瓣环速度峰值之比（E/E′）、收缩末期到二尖瓣开放图像时的舒张容积占整个舒张容积的比值（EDV早/EDV）、收缩末期到二尖瓣开放图像时的时间占整个心动周期的比值（T早/T）,左心室16节段、12节段心肌舒张早期容积的时间标准差（Tedv 16-SD、Tedv 12-SD）及左心室12节段的组织速率舒张峰值时间的标准差（Te 12-SD）,计算舒张早期容积的时间最大差值（Tedv-Dif）,评价左心室舒张早期同步性。结果DCM组舒张功能明显减低,E/E′、EDV早/EDV、T早/T显著大于对照组（P〈0.05）。DCM组Te 12-SD、Tedv 16-SD、Tedv 12-SD均明显大于对照组（均P〈0.01）。Tedv 16-SD、Tedv 12-SD与Te 12-SD的相关性分别为r=0.879和r=0.773（均P〈0.01）;Tedv 16-Dif、Tedv 12-Dif与Te 12-Dif的相关性分别为r=0.850和r=0.718（均P〈0.01）。结论实时三维超声心动图和组织多普勒两种方法均能够评价左心室舒张早期同步性,两种方法的评价结果具有很好的相关性。Objective To compare the clinical value of real-time three-dimensional echocardiography （RT-3DE） and tissue Doppler imaging（TDI） in early diastolic synchrony. Methods A total of 27 healthy volunteers（control group, male 19, female 8; aged 50 - 72 years old, mean age 60.3 years old ） and 37 patients with DCM（DCM group, male 25, female 12; aged 46 - 87 years old, mean age 65.4 years old） were examined by RT-3DE and TDI. The mitral E peak/mitral annular E peak（E/E＇）, percentage of early diastolic/diastolic volume（EDVearlyEDV）, percentage of time of early diastolic/diastolic volume（Tearly/T）, standard deviation of time to early diastolic volume about 16,12 segments（Tedv 16-SD, Tedv 12-SD） and standard deviation of time to peak early diastolic velocity about 12 segrnents（Te 12-SD） were obtained to evaluate synchrony of left ventricular（LV） early diastolic. Results The diastolic function decreased in DCM group, and E/E＇, EDVearly/EDV, Tearly/T of DCM group were larger than control group （P 〈 0.05）, Tel2-SD, Tedv 16-SD, Tedv 12-SD of DCM group were larger than control group（P 〈 0.01）. There was significant correlation among Tedv 16-SD, Tedv 12-SD and Te 12-SD （r = 0.879, r = 0.773, P 〈 0.01）. There was a significant correlation among Tedv 16-Dif, Tedv 12-Dif and Te 12-Dif（r = 0.850, r = 0.718, P 〈 0.01）. Conclusion It is demonstrated that both RT- 3DE and TDI could provide effective methods to assess the LV early diastolic synehrony. The evaluation result of two methods has a good correlation.

关 键 词：实时三维超声心动描记术 左心室功能 心肌病 扩张型 组织多普勒显像 

分 类 号：R445.1[医药卫生—影像医学与核医学]