实时三维超声评价肥厚型心肌病患者左室心肌节段容积与收缩功能的变化  

Evaluation of the left ventricular regional volume and systolic functionin in patients with hypertrophic cardiomyopathy by real-time three-dimensional ultrasound

作　　者：孟庆国[1] 尹立雪[1] 张红梅[1] 黄宇[2] 刘梅[1] 

机构地区：[1]四川省医学科学院四川省人民医院超声医学研究所,成都市610071 [2]泸州医学院

出　　处：《临床超声医学杂志》2015年第5期308-311,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的采用实时三维超声心动图(RT-3DE)评价肥厚型心肌病(HCM)患者左室节段心肌容积与收缩功能的变化。方法非高血压性HCM患者22例为HCM组,体检健康者22例为对照组,于心尖四腔观RT-3DE获得左室17节段的容积-时间曲线和左室射血分数(LVEF)-时间曲线,分析左室节段收缩功能参数:舒张末期容积(EDV)、收缩末期容积(ESV)和LVEF。结果与对照组比较,HCM组左房前后径和室间隔厚度增大,基底段水平前间隔、后间隔,乳头肌水平前壁、前间隔,心尖段水平前壁、间隔LVEF均降低,基底段水平、心尖段间隔及下壁的节段ESV减小(均P<0.05)。两组节段EDV与节段LVEF无相关性;对照组乳头肌及心尖段水平室间隔的ESV与LVEF呈负相关(r值分别为-0.477,-0.501,P<0.05);HCM组乳头肌水平下壁、侧壁和心尖段下壁、下侧壁ESV与LVEF呈负相关(r值分别为-0.549、-0.426、-0.441、-0.424,P<0.05)。结论无任何临床症状的非高血压性HCM患者左室节段心肌功能隐匿性受损,局部异常肥厚节段心肌的收缩功能明显减低;非肥厚区心肌节段容积变化影响节段LVEF。Objective To evaluate regional volume and systolic function of the left ventricular in non-hypertensive patients with hypertrophic cardiomyopathy （HCM） by real-time three-dimensional ultrasound.Methods Twenty-two patients with HCM and 22 cases of healthy subjects as controls were enrolled.In the apical four-chamber view,volume-time curve of 17 left ventricular segments and time-LVEF curve were obtained by RT-3DE.The left ventricular segmental systolic function parameters [end-diastolic volume （EDV）,end-systolic volume （ESV） and LVEF] were analyzed.Results Compared with the control group,LA and IVS increased in HCM group （P＜0.05）.The LVEF of myocardium at abnormal hypertrophy segments decreased （P＜0.05）.The ESV of basal segment and the apical segment at interval and inferior wall decreased （P＜0.05）.There was no correlation between EDV and corresponding segmental LVEF in two groups.ESV was associated with the corresponding segmental LVEF in papillary muscle and septum at apical level in the control group （r were-0.477,-0.501,P＜0.05）.ESV was associated with the corresponding segmental LVEF in inferior and lateral wall at papillary muscle level and inferior,inferiorlateral wall at apical level in the HCM group （r were-0.549,-0.426,-0.441,-0.424,P＜0.05）.Conclusion Segmental myocardial function of left ventricule is occultly impaired in non-hypertensive HCM patients without clinical symptoms,systolic function for Local anomaly hypertrophycardiomyopathy was significantly reduced.

关 键 词：超声心动描记术 三维 心肌病 肥厚性 节段收缩功能 

分 类 号：R540.45[医药卫生—心血管疾病] R542.2[医药卫生—内科学]