超声检测左室整体舒张功能的临床研究  

Clinical Study on Total Diastolic Function of Left Ventricle with Echocardiography

作　　者：刘爱玲[1] 钱蕴秋[1] 李军[1] 郭文怡[1] 张军[1] 周晓东[1] 朱永胜[1] 朱霆[1] 刘丽文[1] 田新桥[1] 

机构地区：[1]第四军医大学西京医院超声诊断科

出　　处：《中国超声医学杂志》2002年第4期256-258,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :检测多项反映左室 (LV)舒张功能的指标 ,研究其敏感性和特异性 ,探讨临床应用的可行性。方法 :59例临床确诊 (其中 30例经冠脉造影证实 )的冠心病 (CAD)患者和正常志愿者 30例 ,常规测心腔大小 ,取不同切面分别测二尖瓣下血流频谱、右上肺静脉 (PV)血流频谱、等容舒张期 (IVRT)、EPSS、LV舒张期彩色 M型 Doppler血流传播速度 (RFP) ;启动声学定量 (AQ)系统 ,测量左室 (LV)、左房 (L A)舒张期面积变化分数、面积及其比值 ,使用 Doppler组织成像 (DTI)测量二尖瓣环舒张期运动速度及其比值。根据二尖瓣下血流频谱形态将 CAD患者分为 4组 ,第 组 :频谱形态正常型 (2≥ E/ A>1 ) ;第 组 :松弛受损型 (E/ A<1 ) ;第 组 :假性正常型 (E/ A>1 ) ;第 组 :限制型 (E/ A>2 )。均与正常组对照。结果 :在反映 LV舒张功能异常 (LVDD)中特异性和敏感性较高且简便易取的指标为 :二尖瓣的 A、 E/ A、 DEC、 EDT、 LA前后径、 IVRT、 RFP和 DTI的 E 、 E /A ;在鉴别“假性正常”频谱时 ,LA前后径、EPSS、 RFP、DTI的 E 、E / A 及 AQ的 RFFAC/ AFFAC、 D/ A是敏感性和特异性较高的一组指标。结论 :二尖瓣血流频谱仍为评价 LV整体舒张功能简便、可行的方法 ,结合 AQ、RFP、DTI等技术可鉴别二尖瓣“假性正常”Objective:To compare the sensitivity and specificity of quotas of echocardiography in assessment of LV diastolic function.Methods:The subjects consisted of 59 patients with coronary artery disease(included 30 confirmed by angiography)and 30 normal volunteers.Dimensions of cardiac chambers,spectra of transmitral?pulmonary vein,IVRT,EPSS,rate of flow propagation in LV in diastole RFP(using color M mode)were measured,and acoustic quantification system(AQ)was activated to display the area time curves of LV or LA,and DTI was used to measure the diastolic velocities of mitral annula.The patients were divided into 4 groups according to the transmitral spectra,group Ⅰ:with normal spectra(1<E/A≤2),group Ⅱ:relaxation damaged(E/A<1),group Ⅲ:with pseudonormalized spectrum,group Ⅳ:with restricted type of spectra(E/A>2).Results:We concluded that parameters deprived from transmitral spectra E/A,A,DEC,EDT,IVRT,anterior posterior dimension of LA,RFP,DTI:E?E/A all have high sensitivty and specificity in detecting left ventricular diastolic dysfunction(LVDD)and can be routinely used.In discrimination of pseudonormalizd ones with anterio posterior dimension of LA,EPSS,RFP?E?E/A of DTI and RFFAC/AFFAC?D/AC all have great sensitivity and specificity,and can be rapidly and simply measured so should be clinically spread.Conclusions:Parameters deprived from transmitral spectra have high sensitivity and specificity in detecting LV diastolic function and can be routinely used.Combing the technology AQ,RFP,DTI can discriminate of pseudonormalizd ones.

关 键 词：冠心病 舒张功能 声学定量 组织成像 血流传播速度 RFP DTI 左心室 Doppler 超声技术 LV 

分 类 号：R445.1[医药卫生—影像医学与核医学]