实时三维超声评价冠状动脉性心脏病患者左室收缩功能及同步性研究  

Evaluation of left ventricular systolic function and synchronization in patients with coronary artery disease by real-time three-dimensional echocardiography

作　　者：田雨[1] 王小凡[1] 吕启凤[1] 姜志荣[1] 

机构地区：[1]青岛大学附属医院心脏超声科,山东省青岛市266000

出　　处：《临床超声医学杂志》2015年第3期155-158,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨实时三维超声(RT-3DE)评价冠状动脉性心脏病(以下简称冠心病)患者左室收缩功能及同步性的应用价值。方法 61例健康志愿者(正常组)及67例冠心病患者(冠心病组)分别进行实时三维超声和常规超声检查,分析比较各种方法所测左室整体、局部收缩功能参数及同步性参数。结果 RT-3DE与双平面Simpson’s法的相关性高于其与M型超声的相关性。RT-3DE估测左室容积低于常规超声。RT-3DE测量从基底段至心尖段容积呈递减趋势,射血分数呈递增趋势;冠心病组的梗死节段左室整体舒张末期容积和整体收缩末期容积均高于正常组相应节段,各节段射血分数均低于正常组相应节段(均P<0.05)。冠心病组左室16节段从QRS波起点到最小收缩容积时间的标准差和最大差值(Tmsv 16-SD、Tmsv 16-Dif),以及用R-R间期校正后的Tmsv 16-SD%、Tmsv 16-Dif%均显著高于正常组,且多支病变患者均高于单支病变(均P<0.05)。结论 RT-3DE能更加精准、客观地评价冠心病患者左室收缩功能及同步性。Objective To investigate the application value of real-time three-dimensional echocardiography（RT-3DE） in evaluating the left ventricular systolic function and wall motion synchronization in patients with coronary heart disease （CHD）. Methods Sixty-one cases of healthy volunteers （normal group） and 67 patients with CHD （CHD group） underwent RT-3DE and conventional echocardiography.The global left ventricular systolic function parameters （gEDV, gESV, gEF） measured by different methods were analyzed.The 17 segments systolic function parameters（rEDV ,rESV,rEF） and wall motion synchrony parameters（Tmsv 16-SD,Tmsv 16-Dif,Tmsv 16-SD%,Tmsv 16-Dif%） measured by RT-3DE were analyzed. Results RT-3DE showed higher correlation with biplane Simpson＇s method than M-mode ultrasound（P〈0.05）.The left ventricular volume estimated by RT-3DE was lower than conventional ultrasound.The volume measured by RT-3DE showed decreasing trend from basal segments to apical segments,while the ejection fraction showed an increasing trend.The systolic function parameters of infarction segments in CHD group were higher than those in normal group,while ejection fraction was lower than that in normal group（P〈0.05）.The Tmsv 16-SD,Tmsv 16-Dff, Tmsv 16-SD% and Tmsv 16-Dff% in CHD group were higher than those in normal group （P〈0.05）. Conclusion RT-3DE can well evaluate the systolic function and wall motion synchronization in CHD patients.

关 键 词：超声心动描记术 三维 实时 冠状动脉性心脏病 收缩功能 左室 同步性 

分 类 号：R540.45[医药卫生—心血管疾病]