室壁运动异常患者左室射血分数超声心动图检测方法的选择  

Selection of the echocardiographic methods for detecting left ventricular ejection fraction in patients with regional wall motion abnormality

作　　者：赵刚[1] 程蕾蕾[2] 裴晓黎[2,3] 宋飞艳 舒先红[2] 

机构地区：[1]复旦大学附属中山医院心内科、上海市心血管病研究所,上海200032 [2]复旦大学附属中山医院心脏超声诊断科、上海市心血管病研究所、上海市影像医学研究所,上海200032 [3]新疆维吾尔自治区喀什地区第二人民医院心内科,喀什844000

出　　处：《中国临床医学》2016年第3期299-302,共4页Chinese Journal of Clinical Medicine

基　　金：复旦大学附属中山医院人才培养计划-优秀骨干计划(2015ZSYXGG04)~~

摘　　要：目的:探讨不同超声心动图指标对左室前壁及前侧壁节段运动异常患者射血分数(LVEF)检测的价值。方法:收集2010年1月至2015年12月在我院住院、超声心动图提示左室前壁及前侧壁节段收缩活动异常的患者21例,采用超声心动图M型、二维和心尖双平面Simpson法测定LVEF,并与经心导管左室造影结果进行对比。结果:左室造影测定的LVEF与M型及二维法差异明显,但与心尖双平面Simpson法相关性良好。进一步以M型测值55%作为界限行亚组分析显示,对于LVEF>55%患者4种方法测定结果差异无统计学意义;而对于LVEF≤55%患者,二维法及M型测得的LVEF高于左室造影法(P<0.05),而此时Simpson法与左室造影法较为一致,差异无统计学意义(P=0.061 1)。结论:对于左室前壁及前侧壁节段运动异常的患者,M型LVEF>55%的患者可直接采纳M型及二维法测值;但若LVEF≤55%,建议行心尖双平面Simpson法测定。Objective：To explore the value of different echocardiographic indices on the detection of left ventricular ejection fraction（LVEF）in patients with left ventricular anterior and anterolateral wall motion abnormalities.Methods：Twenty-one patients with left ventricular anterior and anterolateral wall motion abnormalities were enrolled from Jan.2010 to Dec.2015.The left ventricular ejection fraction（LVEF）of all subjects were measured by M-mode echocardiography,twodimensional echocardiography and apical biplane Simpson＇s method,and were compared with left ventricular angiography.Results：There were obvious differences in LVEF evaluation between left ventricular angiography method and M-mode echocardiography or two-dimensional echocardiography（P〈0.05）,while the correlation between the angiographic method and apical biplane Simpson＇s measurement was good.Further the subgroup analysis with the M-mode measurement of 55% as the boundary showed that there were no significant differences among the four kinds of methods when LVEF is more than or equal to 55%.And in patients with LVEF less than or equal to 55%,LVEF measured by two-dimensional method and M-mode was higher than that of left ventricular angiography（P〈0.05）,and there was no statistical difference between Simpson＇s method and left ventricular angiography（P=0.061 1）.Conclusions：For patients with left ventricular anterior and anterolateral wall motion abnormalities,M-mode or two-dimensional echocardiography can be directly adopted when LVEF is more than or equal to 55% measured by M-mode;but if LVEF is less than or equal to 55%,apical biplane Simpson＇s method is recommended for determination.

关 键 词：节段室壁运动异常 超声心动图 左室造影 射血分数 

分 类 号：R540.45[医药卫生—心血管疾病]