实时三维超声心动图评价双心室再同步化治疗效果  

Evaluation of the cardiac resynchronization therapy by real time three-dimensional echocardiography

作　　者：缪英[1] 郝应禄[1] 李燕萍[1] 廖德荣[1] 钱宝堂[1] 

机构地区：[1]云南省玉溪市人民医院心内科,653100

出　　处：《临床超声医学杂志》2012年第12期805-808,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨实时三维超声心动图(RT-3DE)在双心室再同步化治疗(CRT)慢性心力衰竭中的临床应用价值。方法选取我院成功植入CRT,或带除颤功能的双心室再同步化起搏器治疗的慢性心力衰竭患者16例(CRT组),另选同期相匹配的健康者16例(正常对照组),应用RT-3DE计算两组治疗前及CRT组治疗3个月后左室舒张末容积(LVEDV)、左室收缩末容积(LVESV)、每搏量(SV)、左室射血分数(LVEF)、左室时间-容积参数、标化的时间-容积指标及左室时间-位移指标,并对其进行比较分析。结果 CRT组治疗前LVEDV、LVESV、SV、LVEF以及左室时间-位移指标均较正常对照组增加,差异均有统计学意义(均P<0.05)。治疗3个月后,CRT组EDV、ESV、SV、LVEF均较术前有所改善,但差异均无统计学意义;16、12、6节段达最小收缩容积时间的标准差均降低,位移标准差、位移最大值、位移最小值均减小,与术前比较差异均有统计学意义(均P<0.05)。结论 RT-3DE能够有效评价慢性心力衰竭患者左室收缩同步性及评估CRT临床疗效。Objective To explore the clinical value of the cardiac resynchronization therapy （CRT） by real time three- dimensional echocardiography （RT-3DE） in patients with chronic cardiac heart failure （CHF）. Methods Sixteen patients with CHF, and measured the parameters as following： EDV, ESV, SV, LVEF, the time-volume index of the left ventricle and the standardized time-volume index as well as the time-excursion index of the left ventricle. Results ①Comparing with the control, the values of several time-volume index of the left ventricle in the CHF patients were much great（P〈0.05 ）. Moreover EDV, ESV, SV, LVEF and the time-excursion index of the left ventricle all had significant difference（P〈0.05 ）. ②After the CRT implantation, EDV, ESV, SV, LVEF in the CHF patients increased a fewer than those before the remedy, hut the values of Tmsvl6-SD, Tmsvl2-SD,Tmsv 6-SD （P〈0.05）and Exeursion-SD,Excursion-Max, Excursion-Min all decreased much more （P〈0.05）. Conclusion RT-3DE could evaluate the contract synchrony of the left ventricle and the clinical effect of the CRT remedy in the CHF patients.

关 键 词：超声心动描记术 三维 实时 再同步化治疗 双心室 心力衰竭 

分 类 号：R541[医药卫生—心血管疾病] R540.45[医药卫生—内科学]