缺血性心肌病左室重构变化的超声研究  

Ultrasound Study of the Left Ventricular Remodeling in Patients with Ischemic cardiomyopathy

作　　者：王华[1] 童晓明[1] 于海凤[1] 张秀明[1] 张守民[1] 

机构地区：[1]山东省淄博市中心医院,255036

出　　处：《临床超声医学杂志》2000年第4期219-221,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的　应用二维多普勒超声心动图 (2DDE)评价缺血性心肌病 (ICM )患者左室重构 (LVR)的病理生理改变。方法　用 2DDE对 5 6例ICM患者LVR的病理生理改变引进了研究 ,另有 5 0例正常对照者。指标包括左室舒张末期直径 (LVDD)、左室舒张末期容积 (LVEDV)、左室收缩末期容积 (LVESV)、左室收缩末期室壁应力(ESS)、左室射血分数 (EF)、左室峰值充盈率 (PFR)、峰值流速A (PVA)、峰值流速E (PVE)及左房张力 (LAT)和左房射血力 (LAF)。结果　ICM组的各项指标与正常对照组比较有显著性差异 (P <0 0 1～ 0 0 0 1)。ICM组的LVDD、LVEDV、LVESV、ESS、PVA、LAT、LAF显著增大 ,EF、PVE、PFR及PVA/PVE显著降低 (P <0 0 1～0 0 0 1)。结论　ICM病人的LVR主要与心肌缺血引起的梗塞区膨展、左室扩张、容量负荷和室壁应力增加有关。LVESV、LVEDV及EF可作为了解ICM这期预后的较好指标。Objective To study the pathophysiological changes of the left ventricular remodeling(LVR)in patients with ischemic cardiomyopathy(ICM)by using 2-dimensional Doppler echocardiography(2DDE).Method 56 patients with ICM and 50 normal persons (control group,CG) underwent 2DDE examination.The parameters of 2DDE were the end-diastolic diameter and volume of the left ventricle(LVDD,LVEDV),the end -systolic volume and wallstress of the left ventricle(LVESV,ESS),the ejection force and peak filling rate of the left ventricle (EF,PFR),the peak velocity A and E (PVA,PVE).Results The results shawed that in ICM group LVDD,LVEDV,LVESV,ESS,PVA,LAT and LAF were significantly increased while EF,PVE,PFR and PVA/PVE decreased (P<0.01～0.001).Conclusion The pathophysiological changes of the LVR in patients with ICM are mainly due to the expansion of the infarction district,the increase of overload volume and wall stress of the left ventricl.LVESV,LVEDV are good parameters for predicting LVR.

关 键 词：超声心动图 左室重构 心功能 心肌缺血 

分 类 号：R542.206[医药卫生—心血管疾病] R541.904[医药卫生—内科学]