组织运动瓣环位移技术评价冠状动脉旁路移植术患者左心室纵向收缩功能  

Tissue mitral annular displacement technique in assessing left ventricular longitudinal systolic function in patients with coronary heart disease before and after coronary artery bypass graft

作　　者：刘大伟[1] 赵蕾[1] 陈栋[1] 王永祥[2] 

机构地区：[1]河南省兰考县人民医院外科,河南省兰考县475320 [2]第四军医大学西京医院心脏外科,西安710032

出　　处：《中华实用诊断与治疗杂志》2014年第9期917-919,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的应用组织运动二尖瓣瓣环位移技术(tissue mitral annular displacement,TMAD)测量收缩期二尖瓣环位移(mitral annular displacement,MAD),评价冠心病患者行冠状动脉旁路移植术(coronary artery bypass graft,CABG)F前、后左心室纵向收缩功能变化。方法成功行CABG术冠心病患者47例(冠心病组),分别于术前、术后7d及术后6个月行超声心动图检查获取心尖四腔观、心尖二腔观图像,应用TMAD技术测量二尖瓣环室4个位点(室间隔侧、侧壁侧、下壁侧、前壁侧)MAD,应用双平面法测量二尖瓣环中点收缩期标准化位移(mid-point of mitral annular biplanar normalized displacement,MABND-midpt),并与同期40例体检健康者(对照组)进行比较。结果冠心病组术前、术后7d及术后6个月二尖瓣环4个位点MAD及二尖瓣环中点MABND-midpt均低于对照组(P<0.05);冠心病组术后7d二尖瓣环室间隔侧、侧壁侧、下壁侧、前壁侧MAD((9.1±1.0)、(9.6±0.6)、(9.0±1.2)、(9.2±1.0)mm)及二尖瓣环中点MABND-midpt((10.1±1.0)%)均低于术前((10.2±1.1)、(11.1±0.9)、(10.7±1.0)、(11.1±1.2)mm和(12.7±1.2)%)(P<0.05),术后6个月二尖瓣环室间隔侧、侧壁侧、下壁侧、前壁侧MAD((12.1±0.7)、(12.6±0.6)、(12.3±1.0)、(12.6±1.2)mm)及二尖瓣环中点MABND-midpt((14.5±1.1)%)均高于术前(P<0.05)。结论 CABG术后冠心病患者左心室长轴收缩功能改善,但仍低于正常水平,TMAD可用于评价CABG治疗冠心病的效果。Objective To assess the change of left ventricular longitudinal systolic function in patients with coronary heart disease （CHD） before and after coronary artery bypass graft by detecting mitral annular displacement （MAD） with tissue MAD technique. Methods Forty-seven patients with CHD （CHD group） underwent standard echocardiography to obtain images of apical four-chamber view and apical two-chamber view before, and in 7 days and 6 months after operation, underwent tissue MAD to measure MAD at the four sites （septal, lateral, inferior and anterior sites）, and were measured mid-point of mitral annular biplanar normalized displacement （MABND-midpt） by biplane methods. All parameter were compared with 40 healthy volunteers （control group）. Results MAD values at the four sites and MABND-midpt were lower in CHD group before, and in 7 days and 6 months after operation than those in control group （P〈0. 05）. MAD values at the septal, lateral, inferior and anterior sites, and MABND-midpt were （9. 1± 1.0） mm, （9.6±0.6） mm, （9.0±1.2） mm, （9.2±1.0） mm and （10. 1±1.0）% in 7 days after operation, significantly lower than those before operation （（10.2±1. 1） mm, （11. 1±0. 9） mm, （10. 7±1.0） ram, （11. 1±1. 2） mm, （12. 7± 1.2）%） （P〈0.05）, and were （12. 1±0.7） mm, （12. 6±0. 6） mm, （12.3± 1.0） mm, （12. 6± 1.2） mm, （14. 5± 1.1）% in 6 months after operation, significantly higher than those before operation （P 〈 0.05） in CHD group. Conclusion Left ventricular longitudinal systolic function is improved in CHD patients after coronary artery bypass graft, but is still lower than the normal level. Tissue MAD can be used to assess the effect of coronary artery bypass graft on CHD.

关 键 词：冠心病 冠状动脉旁路移植术 组织运动瓣环位移技术 左心室纵向收缩功能 

分 类 号：R654.2[医药卫生—外科学]