超声组织多普勒对完全性左束支传导阻滞心房同步性研究  

The synchrony evaluation of atrial in patients with complete left bundle branch block by using tissue Doppler imaging

作　　者：刘言 徐锦媚 于蓝 田永梅 张铁山[2] 

机构地区：[1]煤炭总医院超声科,北京市100028 [2]北华大学附属医院超声科

出　　处：《中国心血管病研究》2017年第12期1105-1107,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的 应用超声组织多普勒技术（TDI）观察完全性左束支传导阻滞（CLBBB）合并或不合并心衰患者心房同步性变化.方法 选取煤炭总医院30例CLBBB患者,根据左室射血分数（LVEF＞50％,LVEF＜50％）进行分组.病例Ⅰ组16例CLBBB患者且LVEF＞50％;病例Ⅱ组14例CLBBB患者且LVEF＜50％;正常对照组20例.上述受检者均进行常规超声及组织多普勒检查.于心尖四腔切面获取左房游离壁、房间隔及右房游离壁瓣环下3个取样点的Q-TVI曲线,测量从心电图P波起点至心房收缩（舒张晚期）速度峰值的时限Ta,计算L-Ta与IAS-Ta差的绝对值、IAS-Ta与R-Ta差的绝对值、L-Ta与R-Ta差的绝对值,从而反映心房内及心房间的同步性情况.结果 病例Ⅱ组患者L-Ta及IAS-Ta较对照组和病例Ⅰ组显著延长（P＜0.01,P＜0.01）,且右房内不同步性较对照组和病例Ⅰ组显著增加（P＜0.01）;病例Ⅱ组患者左房内及心房间不同步性较对照组显著的增加（P＜0.05,P＜0.05）,而病例Ⅰ组患者与对照组比较未见统计学差异.结论 CLBBB合并心衰的患者存在心房内及心房间的不同步运动.Objective To evaluate the patients of complete left bundle branch block （CLBBB） with or without heart failure in synchrony of atrial by using tissue Doppler imaging.Methods 30 patients with CLBBB admitted from Meitan General Hospital were divided into two groups according to patients with or without heart failure.Group Ⅰ：sixteen CLBBB patients without heart failure（LVEF〉50%）;group Ⅱ：fourteen CLBBB patients with heart failure （LVEF〈50%）;control group：twenty healthy adults.The echocardiography images and the function of tissue velocity imaging in all the subjects were obtained and analyzed.The QTVI of the left atrial free wall,interatrial septum and right atrial free wall were observed in the apical four-chamber.As to assess the synchronicity of atrial,the time from the beginning of p to peak late diastolic velocity （Ta） and the time of absolute difference between L-Ta and IAS-Ta,between IAS-Ta and R-Ta,between L-Ta and R-Ta were measured.Results L-TA and IAS-Ta of group Ⅱ has longer time than control group and group Ⅰ （P〈0.01,P〈0.01）.The asynchronism of right Inter-atrial synchronicity was increased in group Ⅱ （P〈0.01）.Meanwhile the asynchronism of left Inter-and Intra-atrial synchronicity was increased in group Ⅱ compared with control group （P〈0.05,P〈0.05）,but the parameters had no significant statistics in group Ⅰ.Conclusion The patients of CLBBB with heart failure can cause inter-atrial asynchronism and intra-atrial asynchronism

关 键 词：心房 组织多普勒 柬支传导阻滞 同步性 

分 类 号：R540.45[医药卫生—心血管疾病]