超声新技术在慢性心衰心脏同步性检测中的临床应用  

Clinical Application of Advanced Echocardiography in Cardiac Mechanical Contraction Synchronization Test in Patients with Heart Failure

作　　者：丁成彦 戴海龙[1,2] 左明鲜[1,2] 盖起明[1,2] 丁云川[1,3] 王庆慧[1,3] 光雪峰[1,2] 

机构地区：[1]昆明医科大学附属延安医院 [2]云南心血管病医院心内科,云南昆明650051 [3]云南心血管病医院功能科,云南昆明650051

出　　处：《昆明医科大学学报》2013年第12期44-48,共5页Journal of Kunming Medical University

基　　金：云南省自然科学基金资助项目(2010CD209)

摘　　要：目的使用超声新技术对慢性心衰(CHF)患者进行心脏收缩非同步性检测,并对左室射血分数与心脏非同步性指标的相关性及DTI、STI、RT-3DE之间的相关性进行研究.方法选择正常对照组(20例)、CHF并窄QRS组(10例)、CHF并宽QRS组(12例),共3组.使用TDI、STI、RT-3DE评价心脏收缩不同步性.观察心功能改善情况与心脏同步性改善程度的相关性,以及DTI、STI、RT-3DE之间的相关性.结果 (1)CHF患者(包括窄QRS组、宽QRS组)心脏收缩非同步性指标高于正常对照组(P<0.05);(2)术前心脏收缩非同步性指标在宽、窄QRS组间差异无统计学意义(P>0.05);(3)术前、术后心脏收缩非同步性指标在CHF患者(包括宽QRS组、窄QRS组)中差异有统计学意义(P<0.05);(4)术后心脏收缩非同步性指标在窄QRS组、宽QRS组间差异无统计学意义(P>0.05);(5)LVEF与心脏非同步性指标显著负相关(P<0.01);(6)在心脏非同步性指标中,DTI与STI、RT-3DE呈显著正相关性(P<0.01).结论使用心脏超声新技术筛选CHF患者,对于左室不同步(包括窄QRS波)者,亦可通过CRT获益.Objective To test synchronization of cardiac mechanical contraction by echocardiography and investigate the correlation of left ventricular ejection fraction （LVEF） mechanical dyssynchrony, and the relationship between DTI, STI and RT-3DE. Methods means of advanced and the indexes of Control group （20 cases） , chronic heart failure with a widened QRS complex （12 cases） and chronic heart failure with a shortened QRS duration （10 cases） were selected. We evaluated mechanical dyssynchrony with the DTI, the STI and the RT-3DE, and analyzed the correlation between the improvement degree of cardiac function and indexes of mechanical dyssynchrony, and the correlation between DTI, STI and RT-3DE. Results （1） In CHF groups （including shortened QRS group and widened QRS group） , the indexes of synchronization of cardiac mechanical contraction were higher than control group （P〈0.05） （2） However, the indexes of mechanical dyssynchrony before operation showed no statistically significant difference between the widened QRS group and the shortened QRS group （P〉0.05） . （3） In CHF groups （including shortened QRS group and widened QRS group） , the indexes of mechanical dyssynchrony before operation were higher more than after operation （P 〈0.05） postoperation, the indexes of mechanical dyssynchrony showed no statistically significant difference （4） In between the widened QRS group and the shortened QRS group （P〉0.05） . （5） There was a significant negative correlation between the LVEF and the indexes of mechanical dyssynchrony （P〈0.01） （6） .In the indexes of synchronization of cardiac mechanical contractions, there are significant positive correlations between the DTI, the STI and the RT-3DE （P〈0.01） . Conclusion Echocardiography can be used to screen CHF patients, and patients with left ventricular synchronous （ including shortened QRS duration） can also be benefited from CRT.

关 键 词：超声新技术 机械收缩同步性 心力衰竭 

分 类 号：R445.1[医药卫生—影像医学与核医学]