解剖M型超声在早期心肌缺血左室舒张特性诊断中的应用  

The left ventricular diastolic characteristics of early myocardial ischemia detected by using anatomical M-mode echocardiography

作　　者：刘学兵[1] 尹立雪[1] 邓燕[1] 陆景[1] 张清凤[1] 

机构地区：[1]四川省医学科学院.四川省人民医院心血管超声及心功能科,四川成都610072

出　　处：《实用医院临床杂志》2015年第6期28-30,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨解剖M型超声在早期心肌缺血左室舒张期局部心内膜位移变化特征诊断中的应用。方法 45例患者根据单光子发射型计算机断层扫描结果分为心肌缺血患者28例(缺血组)及正常者17例(正常组)。采集左室短轴中段动态超声图像,采用解剖M型超声经前间隔-后壁、后间隔-侧壁及前壁-下壁节段3条取样线,分别测量各节段舒张早期速度、幅度及幅度率,计数心内膜面收缩后收缩及短暂舒张延迟的节段数。比较两组舒张变化特征。结果与正常组比较,缺血组缺血节段舒张早期幅度、幅度率更低(P<0.05),收缩后收缩及短暂舒张延迟更多(P<0.01),两组舒张早期速度差异无统计学意义(P>0.05)。结论解剖M型超声可作为一种检测局部心肌舒张功能的简便方法,舒张期局部心内膜位移的异常变化可为诊断早期心肌缺血提供有价值的参考。Objective To investigate the application of M-mode echocardiography in the diagnosis of displacement changes of left ventricular diastolic endocardium in early myocardial ischemia. Methods Forty-five patients were divided into ischemia group（ n= 28） and normal group（ n = 17） according to the results of single photon emission computed tomography（ SPECT）. The dynamic ultrasound images of the middle section at the left ventricular short axis were collected. The diastolic early velocity,amplitude and amplitude rate were measured by using 3 sampling lines of anatomy M-mode echocardiography via anterior septal to posterior wall,posterior septal to lateral wall and anterior wall-inferior wall. The number of segments of post-systolic shortening（ PSS） and short diastolic delay（ SDD） on cardiac intima were observed. Diastolic characteristics of ischemia group and normal group were compared between the two groups. Results The diastolic early amplitude and amplitude rate of ischemic segment in the ischemia group were lower than that of the normal group（ P〈0. 05）. PSS and SDD in the ischemia group were more than that in the normal group（ P〈0. 05）. There was no statistical significance in early diastolic speed between the two groups（ P〉0. 01）. Conclusion The anatomic M mode ultrasound can be used as a simple method to detect diastolic function. The abnormal changes of diastolic endocardial local displacement could provide valuable reference for diagnosis of early myocardial ischemia.

关 键 词：M超声心动图 冠心病 舒张期 心内膜位移 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]