定量组织速度成像评价二尖瓣置换术后左、右心室长轴方向运动特点  

Evaluation of Long-axis Motions of the Ventricular after Mitral Valve Replacement by Quantitative Tissue Velocity Imaging

作　　者：武俊[1] 夏稻子[1] 李阳[1] 林萍[1] 张东明[2] 戴力[2] 

机构地区：[1]大连医科大学附属第二医院超声科,辽宁省大连市116027 [2]大连医科大学附属第二医院心外科,辽宁省大连市116027

出　　处：《中国超声医学杂志》2013年第2期117-120,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的通过定量组织速度成像评价二尖瓣置换术后左、右心室长轴方向运动特点。方法二尖瓣置换术的患者60例分为A、B两组,A组患者35例于二尖瓣置换术同期行三尖瓣人工瓣环成形术,B组患者25例为二尖瓣置换术同期未行三尖瓣手术,另选取健康对照组20例。分别于术前、术后2周通过超声心动图测量左室射血分数(LVEF)和右室射血分数(RVEF),定量组织速度成像测量二、三尖瓣环收缩期峰值速度(Vs),舒张早期峰值速度(Ve),舒张晚期峰值速度(Va)和收缩期位移(Ds)。结果 A组与B组术前二尖瓣环Vs、Va、Ds及LVEF与对照组相比均显著减低,术后Vs、Ve、Va及LVEF均较术前减低(P<0.05);A组术前三尖瓣环Vs、Va、Ds及RVEF与对照组相比均显著减低,术后A组与B组三尖瓣环Vs、Ve、Va、Ds均较术前减低(P<0.05),而RVEF虽有所减低,但差异无统计学意义(P>0).05);A组术前二、三尖瓣环Ve/Va>1,术后Ve/Va<1;B组术前Ve/Va<1,术后Ve/Va>1。结论二尖瓣置换术的患者术后左、右室长轴方向收缩运动均减低,术后LVEF减低,而RVEF无显著减低;二尖瓣置换术患者术后左、右心室舒张功能发生改变。Objective To assess the longaxis rnotions of the ventricular after mitral valve replacement （MVR） by quantitative tissue velocity imaging（QTVI）. Methods 60 patients undergoing MVR were divided into two groups. 35 patients undergoing MVR and tricuspid annuloplasty were in group A, and 25 patients undergoing MVR only were in group B, 20 healthy volunteers were chosen as controls. LVEF and RVEF were measured first. Vs, Ve, Va, Ds were measured by QTVI preoperatively and postoperatively. Results Vs,Va,Ds of the mitral valve annul and LVEF in group A and B were lower than that of controls. Vs, Ve, Va and LVEF in group A and B were decreased significant ly after operation（P〈0.05）. Vs,Va,Ds of the tricuspid valve annul and RVEF in group A were lower than that of controls（P〈0.05）. Vs,Ve,Va and Ds of the tricuspid valve annul and LVEF in group A and B were decreased signifi cantly after operation（P〈0.05）. Although RVEF in group A and B were decreased slightly after operation, but the difference was not significant （P〈0.05）. Ve/Va was different in three groups before operation, it was also changed after operation. Conclusions The longaxis motions of the two ventricular after MVR were decreased; LVEF was de creased but RVEF was not decreased. Moreover the diastolic function of the two ventriculars were changed after oper ation.

关 键 词：超声心动图 二尖瓣置换术 三尖瓣成形术 组织速度成像 

分 类 号：R654.2[医药卫生—外科学] R540.45[医药卫生—临床医学]