法乐氏四联症患儿采用实时三维超声心动图评价法诊断右心室整体和局部容积及收缩功能的临床意义  

Evaluation of right ventricular part and whole volume and systolic function in children with tetralogy of Fallot by real-time three-dimensional echocardiography

作　　者：刘芳 耿红彬 李新 LIU Fang;GENG Hong-bin;LI Xin(Department of Ultrasonography,The Second Hospital of Shaanxi Tongchuan Mining Bureau,Tongchuan,Shaanxi 727004,China;Tongchuan Vocational and Technical College of Shaanxi,Tongchuan,Shaanxi727000,China;Department of Ultrasonography,The People′s Hospital of Tongchuan,Shannxi 727000,China)

机构地区：[1]陕西铜川矿务局第二医院超声科,陕西铜川727004 [2]陕西省铜川市职业防治院,陕西铜川727000 [3]陕西省铜川市人民医院超声医学科,陕西铜川727000

出　　处：《岭南心血管病杂志》2018年第3期284-288,292,共6页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨实时三维超声心动图(real-time three-dimensional echocardiography,RT-3DE)诊断法乐氏四联症(tetralogy of Fallot,TOF)患儿右心室(right ventricle,RV)整体和局部容积及收缩功能的临床价值。方法对2014年2月至2016年6月陕西铜川矿务局第二医院46例TOF患儿(TOF组)、30例正常儿童(对照组)进行RT-3DE检查。采用Tom Tec RV-Function软件定量分析RV RT-3DE图像,测量RV局部与整体的舒张末期容积(enddiastolic volume,EDV)、收缩末期容积(end-systolic volume,ESV)、射血分数(ejection fraction,EF)等参数,并进行组间比较,统计分析测量者自身及测量者间的一致性。结果与对照组相比,观察组的R-R间期、RVEF显著降低(P<0.05),而RVEDV、RVESV、RVSV和RV基底部横径(RV anteroposterior diameter,RVD2)显著提高,差异有统计学意义(P<0.05)。在RV流入道,TOF组的EF显著低于对照组,差异有统计学意义(P<0.05);在RV心尖小梁部,TOF组的EDV和ESV均显著高于对照组,差异有统计学意义(P<0.05);在RV流出道,TOF组的ESV显著高于对照组(P<0.05),而EF显著低于对照组,差异有统计学意义(P<0.05)。Bland-Altman曲线分析结果显示,Tom Tec RV-Function分析软件测得的RVEDV、RVESV、RVEF在观察者自身和观察者内具有较好的重复性。结论 RT-3DE可作为诊断TOF患儿RV整体和局部容积及收缩功能的有效方法。Objectives To assess right ventricular（RV）part and whole volume and systolic function in children withtetralogy of Fallot（TOF）by real-time three-dimensional echocardiography（RT-3DE）. Methods Totally 46 childrenwith TOF（TOF group）and 30 normal children（control group）were examined with RT-3DE from February 2014 toJune 2016 in The Second Hospital of Shaanxi Tongchuan Mining Bureau. Volumetric RT-3DE images were analyzed byTomTec RV-Function software which provided part and whole end-diastolic volume（EDV）,end-systolic volume（ESV）and ejection fraction（EF）. RT-3DE quantitative data were analyzed to test repeatability. Results Comparedwith control group,R-R interval and the RVEF of TOF group significantly decreased（P〈0.05）,while RVEDV,RVESV,RVSV and RV anteroposterior diameter（RVD2）significantly increased（P〈0.05）. In RV inflow tract,EF ofTOF group was significantly lower than that of control group（P〈0.05）. In RV apex trabeculae,EDV and ESV of TOFgroup were significantly higher than those of control group（P〈0.05）. In RV outflow tract,ESV of TOF group wassignificantly higher than that of control group（P〈0.05）,while EF was significantly lower than that of control group（P〈0.05）. Results of the Bland-Altman curve analysis showed that RVEDV,RVESV,RVEF measured by TomTec RVFunctionanalysis software in inter-observer and intra-observer were well reproducible. Conclusions RT-3DE can be used as an effective method for diagnosis of RV part and whole volume and systolic function in children with TOF.

关 键 词：法乐氏四联症 实时三维超声心动图 右心室 容积 收缩 

分 类 号：R541.1[医药卫生—心血管疾病]