不同亚型左束支传导阻滞患者左心室功能及同步性的评价  

Evaluation of Left Ventricular Function and Synchrony in Patients of Complete Left Bundle Branch Block with Different SuBTypes

作　　者：李光源[1] 马春燕[1] 王永槐[1] 关正宇[1] 李阳[1] 金炫佚[1] 杨军[1] 

机构地区：[1]中国医科大学附属第一医院心血管超声科,沈阳市110001

出　　处：《中国超声医学杂志》2017年第5期427-430,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金(No.81401413)

摘　　要：目的采用二维斑点追踪技术(STE)评价不同亚型的CLBBB患者左心室功能及同步性。方法选择CLBBB患者80例,根据T波方向在I、V5或V6导联与QRS主波方向是否相同,将其分为同向型(cLBBB)组和异向型(dLBBB)组。健康者40例作为对照组。采用STE检测左心室心肌整体纵向峰值应变(LS-G)和左心室18节段心肌纵向应变达峰时间的标准差(SDt)。结果 (1)cLBBB组及dLBBB组SDt均大于对照组(P<0.01);且dLBBB组SDt大于cLBBB组(P<0.05)。(2)cLBBB组及dLBBB组LS-G及LVEF显著小于对照组(P<0.01);且dLBBB组小于cLBBB组。(3)与对照组比较,cLBBB组及dLBBB组E/A及EDT减小,E/e′增大(P<0.05),而后两组无显著差异。结论 CLBBB患者左心室功能及收缩同步性减低,且异向型CLBBB患者减低更显著。Objective To evaluate left ventricular function and synchrony in patients with different suBTupps of com- plete left bundle branch block （CLBBB） by Two-dimensional speckle tracking echocardiography （STE）. Methods 80 patients of CLBBB were included and divided into group cLBBB （concordant CLBBB）, and group dLBBB （disconcordant CLBBB）, based on whether the T wave in lead I, V5 or V6 was concordant with QRS wave or not. Moreover, 40 healthy people were selected as control group. Left ventricle global longitudinal peak stain （LS-G）, and Standard deviation of time（SDt） to peak systolic strain for the 18 left ventricular segments were measured by STE. Results （1） The values of SDt in both group eLBBB and dLBBB were higher than that of control group （P〈0.01）. The values of SDT in group dLBBB were higher than that of cLBBB group. （2） The values of LS-G in both group cLBBB and group dLBBB were significantly lower than that of control group. And the value of LS-G in group dLBBB were significantly lower than that of cLBBB （P〈0. 01）. （3） Compared with control group, there was significant decrease of E/A and EDT value in both cLBBB group and dLBBB group, and there was significant increase of E/e＇ value in both cLBBB and dLBBB group（P〈0.05）. There were no significant difference between cLBBB group and dLBBB group. Conclusions The left ventricular function and synchrony in patients with CLBBB are decreased and decreased significantly in dLBBB group.

关 键 词：不同亚型 完全性左束支传导阻滞 左心室功能及同步性 二维斑点追踪技术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.7[医药卫生—诊断学]