实时三维超声心动图对心脏再同步化治疗疗效的评价  

Assessment of therapeutic response to cardiac resynchronization therapy in patients by real-time three-dimentional echocardiography

作　　者：金朝龙[1] 史学功[1] 范雷雷[1] 汪太平[1] 陈宏博[1] 肖洁[1] 

机构地区：[1]安徽医科大学第一附属医院心血管内科彩超室,合肥230022

出　　处：《安徽医科大学学报》2012年第11期1343-1346,共4页Acta Universitatis Medicinalis Anhui

摘　　要：目的应用实时三维超声心动图(RT-3DE)技术评价心脏再同步化治疗(CRT)患者的疗效。方法选择行植入CRT的患者20例,分别于起搏前、起搏后1周、起搏后3个月和起搏后6个月用探头获取左心室的全容积实时三维超声图像,应用Qlab分析软件,得到左室整体与17节段时间-容积曲线,记录左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室射血分数(LVEF)、左室16、12、6节段达最小容积点时间(Tmsv)的标准差(Tmsv 16-SD、Tmsv 12-SD、Tmsv 6-SD)和最大时间差(Tmsv 16-Dif、Tmsv 12-Dif、Tmsv 6-Dif)。结果术后1周内左室整体功能参数较术前无明显改善,而左室不同步参数较术前降低(P<0.05)。术后3个月时左室整体功能参数及左室不同步参数均较术前及术后1周有明显改善(P<0.01)。术后6个月时左室整体功能参数及左室不同步参数均较术前及术后1周有明显改善(P<0.01),但与术后3个月左室整体功能参数及左室不同步参数无改善。结论 CRT可明显改善心力衰竭患者的心功能,RT-3DE能评价左室收缩同步性和收缩功能。Objective To assess the therapeutic response to cardiac resynchronization therapy （CRT） in patients by real-time three-dimensional echoeardiography （RT-3DE）. Methods 20 patients with CRT were included in the study. Probe was used to perform left ventricular full volume real-time three-dimensional echocardiography （RT- 3DE） before,one week after CRT,three month after CRT and six month after CRT. The global and 17-segmental volume curves were obtained by the on-line ventricular ejection fraction（LVEF） , the dispersion of time to minimum regional volume for 16,12,6 left ventricular segment （ Tmsv 16-SD, Tmsv 12-SD, Tmsv 6-SD）, and the maximum difference of time to minimum regional volume for 16,12,6 left ventricular segment （Tmsv 16-Dif, Tmsv 12-Dif, Tmsv 6-Dif）. Results Within 1 week after CRT, parameters of left ventrieular global function had no significant improvement, but the left ventrieular dyssynchrony index reduced significantly （P 〈 0. 05 ） compared with those be- fore CRT. At the 3-month follow-up, the left ventricular global function and the left ventricular dyssynchrony index were all improved significantly compared with those before CRT and one week after CRT （ P 〈 0. 01 ）. At the 6- month follow-up, the left ventrieular global function and the left ventricular dyssynchrony index were all improved significantly compared with those before CRT and one week after CRT（P 〈 0.01 ）. But there was no obvious differ- ence in the left ventricular global function and the left ventricular dyssynchrony index compared with those 3 months after CRT. Conclusion CRT could significantly improve the cardiac function in patients with heart failure. RT-3DE can be used to evaluate the LV systolic function and synchrony.

关 键 词：超声心动图 实时三维 慢性心力衰竭 三腔起搏器 心室再同步化治疗 

分 类 号：R540.4[医药卫生—心血管疾病]