超声组织速度成像Tei指数评价美沙酮替代治疗对吸毒者左心室功能的影响  

Assessment of left ventricular function by tissue velocity imaging Tei index in drug addicts with methadone replacement therapy

作　　者：孙燕 秦华[1] 陈慧惠 

机构地区：[1]杭州职业病防治院特检科,310014 [2]浙江大学

出　　处：《浙江医学》2017年第7期525-528,共4页Zhejiang Medical Journal

基　　金：杭州市卫生科技计划项目(2013A55)

摘　　要：目的通过组织速度成像(TVI)测量左心室Tei指数评价美沙酮替代治疗(MMT)吸毒者的左心室功能影响,了解MMT对患者左心室功能水平的影响。方法选取79例行MMT的吸毒患者分为3组:A组31例,吸毒年限1~3年;B组33例,吸毒3~6年;C组15例,吸毒>6年。选取67例健康体检者为正常对照组(D组)。对4组进行常规超声参数测定及分别用脉冲波多普勒(PW)法和TVI法测定Tei指数。结果 (1)超声心动图二维及心功能部分参数:A组与D组比较差异无统计学意义(P>0.05);B组除E/A(P<0.05)外,其他参数与A、D两组比较无统计学差异;C组E/A与B组比较差异有统计学意义(P<0.05),其他参数与A、B、D组比较差异均有统计学意义(P<0.05或0.01)。(2)使用PW法和TVI法,A、D两组Tei指数差异均无统计学意义(均P>0.05),B、C两组与A、D组比较,差异均有统计学意义(P<0.05或0.01)。采用TVI法,B、C组比较差异有统计学意义(P<0.05),但是PW法检测Tei指数无统计学差异(P>0.05)。(3)平均超声获得率:PW-Tei 65%,TVI-Tei 79%。结论 TVI技术可作为评价吸毒者损害早期左心室功能变化的手段之一。Tei指数能简便、灵敏、综合评价心脏的整体收缩舒张功能,有助于早期发现MMT患者左心室收缩、舒张功能障碍。Objective To assess left ventricular function Tei index in drug addicts with methadone replacement therapy（MMT） by tissue velocity imaging（TVI）.Methods Seventy nine drug addicts undergoing MMT were enrolled in the study,including 3 1 cases with 1-3 year drug use history（group A）,33 cases with 3-6 year history（group B） and 15 cases with 〉 6 year history（group C）,67 healthy subjects served as normal controls（group D）.All subjects underwent Echocardiographic examination,the routine ultrasonic parameters were measured and the Tei index was determined by pulse wave（PW） and TVI methods,respectively.Results Echocardiographic parameters of two dimensional and cardiac function showed there was no significant difference between groups A and D（P 〉0.05）,between groups B and A,B and D except E/A;there were significant differences in all parameters between group C and other 3 groups（P〈0.01 or 0.05）.There was no significant difference in Tei index measured by PW and TVI in group D and group A（P 〉 0.05）,while there was significant difference between groups B,C and groups A,D（P〈 0.01）.There was no significant difference in Tei index measured by PW between groups B and C,while in Tei measured by TVI there was significant difference between groups B and C（P〈0.05）.The ultrasound acquisition rate of Tei measured by PW or TVI was 65%and 79%,respectively.Conclusion Tissue velocity imaging can be used to evaluate the left ventricular function in the early stage of drug abuse.Tei index is simple,sensitive and comprehensive in evaluation of the overall systolic and diastolic function ofthe heart.

关 键 词：TEI指数 吸毒 美沙酮替代治疗 左心室功能 

分 类 号：R540.45[医药卫生—心血管疾病]