实时三维经胸超声心动图检测二尖瓣成形术前后左心房功能的变化及临床意义  

Detection of the Changes of Left Ventricular Function before and after Mitral Valvuloplasty by Real Time Three Dimensional Transthoracic Echocardiography and Its Clinical Significances

作　　者：王翔 王灵通 胡志强[3] 黄小伟 朱英娟 曹新 WANG Xiang;WANG Ling-tong;HU Zhi-qiang;HUANG Xiao-wei;ZHU Ying-juan;CAO Xin(Department of Ultrasound,Wuxi Mingci Institute of Cardiovascular Diseases,Wuxi,Jiangsu,214000,China;Special Laboratory Department,Affiliated hospital of Shandong University of Traditional Chinese Medicine,Ji＇nan,Shandong,250011,China;First Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou,Zhejiang,310000,China)

机构地区：[1]江苏无锡明慈心血管病医院超声科,江苏无锡214000 [2]山东中医药大学附属医院特检科,山东济南250011 [3]浙江大学医学院附属第一医院,浙江杭州310000

出　　处：《现代生物医学进展》2018年第14期2692-2695,共4页Progress in Modern Biomedicine

基　　金：山东省教育厅科研基金项目(J121ko09)

摘　　要：目的:探讨实时三维经胸超声心动图检测左心房(LA)功能以评价二尖瓣成形术(MVR)疗效的价值。方法:选择87例二尖瓣关闭不全患者(病例组)分别在MVR术前及术后1 w、24 w采取实时三维经胸超声心动图检测LA的最大容积(maximum volume of LA,LAV_(max))、最小容积(the minimum volume of LA,LAV_(min))、收缩前容积(systolic volume,LAV_p)及射血分数(ejection fraction,LAEF)、被动射血分数(passive ejection fraction,LAPEF)及主动射血分数(active ejection fraction,LAAEF)等指标,并与同期80例健康志愿者作对照。结果:病例组术前LAV_(max)I、LAV_(min)I、LAV_pI、LAEF、LAPEF、LAAEF值与对照组比较差异有统计学意义(P<0.05),术后1 w、24 w,LAV_(max)I、LAV_(min)I、LAV_pI、LAEF、LAPEF持续改善(P<0.05),LAPEF无明显变化(P>0.05)。术后24 w,LA严重扩张由术前58.6%降低到12.6%,67.8%发生LA重构。结论:实时三维经胸超声心动图显示MVR术后LA容积与功能好转,对评价MVR的疗效有一定价值。Objective： To evaluate the clinical value of real-time three-dimensional transthoracic echocardiography for detecting the left atrium（LA） function in mitral valvuloplasty（MVR）. Methods： The maximum volume of LA（LAVmax）, minimum volume（LAVmin）,systolic volume（LAVp） and ejection fraction（LAEF）, passive ejection fraction（LAPEF） and active ejection fraction（LAAEF） of 87 cases of patients with mitral regurgitation（case group） were examined by real time three-dimensional transthoracic echocardiography respectively before and at 1 week and 24 weeks after MVR, and compared with 80 healthy volunteers in the same period. Results： The preoperative LAVmaxI, LAVminI, LAVpI, LAEF, LAPEF and LAAEF values between the case group and the control group were statistically significant（P〈0.05）, the LAVmaxI, LAVminI, LAVpI, LAEF and LAPEF values from MVR 1w to 24w were continuously improvement（P〈0.05）,while the LAPEF values showed no obvious change（P〉0.05）. At 24 weeks postoperation, the proportion of severe LA dilatation decreased from 58.6 % to 12.6 %, and LA remodeling was found 67.8 % cases. Conclusions： Real time three-dimensional transthoracic echocardiography showed LA volume and functional improvement after MVR, which was of some value in evaluating the curative effect of MVR.

关 键 词：三维 超声心动图 二尖瓣成形术 左心房 

分 类 号：R654.2[医药卫生—外科学] R540.45[医药卫生—临床医学]