血流向量图技术对急性前壁心肌梗死患者左室重构程度、收缩功能和血液流场变化的评价  

Evaluation of the Left Ventricular Remodeling Degree,Systolic Function and Blood Flow Field in Patients with Acute Anterior Wall Myocardial Infarction by Vector Flow Maping

作　　者：周丽[1] 孙艳娟[2] 纳丽莎[1] 刘丽文 王芳[1] 叶晶晶[1] ZHOU Li;SUN Yanjuan;NA Lisha;LIU Liwen;WANG Fang;YE Jingjing(Department of Cardiac Functions Examination,the General Hospital of Ningxia Medical University,Yinchuan 750004;Department of Ultrasound,the General Hospital of Ningxia Medical University,Yinchuan 750004;Department of Ultrasound,Xijing Hospital,Air Force Military University,Xi＇ an 710032)

机构地区：[1]宁夏医科大学总医院心功能检查部,银川750004 [2]宁夏医科大学总医院超声科,银川750004 [3]空军军医大学西京医院超声诊断科,西安710032

出　　处：《宁夏医科大学学报》2018年第5期523-526,共4页Journal of Ningxia Medical University

基　　金：国家自然科学基金(81170305)

摘　　要：目的应用血流向量图(vector flow maping,VFM)技术评价急性前壁心肌梗死后患者等容收缩期左心室涡流参数与左室重构程度及收缩功能间的相关关系。方法收集32例经临床诊断为急性前壁心肌梗死患者作为病例组,同期健康体检者50例作为对照组,测量其心脏大小、左室收缩功能及左心室球形指数(spericity index,SI)等参数。在VFM涡流显像模式下测量其等容收缩期涡流各参数并两组相比较。对病例组等容收缩期不同部位涡流参数与左心室SI和左室射血分数(ejection fraction,EF)做相关性分析。结果对照组等容收缩期形成充满整个心腔的整体涡流,病例组等容收缩期形成分别以基底部非梗塞区和心尖部梗塞区为主的局部涡流,基底部涡流各参数与对照组整体涡流差异均无统计学意义(P均>0.05);心尖部涡流与对照组相比较,涡流量(Qmax)减小,涡核面积(S)增大,涡流强度(vortex intensity,VI)减小(P均<0.05)。基底部涡流与心尖部涡流比较,Qmax和VI增大、S减小(P<0.01)。病例组患者基底部VI与左室SI、EF呈正相关(r=0.757、0.667,P=0.000),其余参数与左室SI、EF均无相关性(P均>0.05)。结论 VFM技术从心腔内流体力学角度为冠心病急性心肌梗死后左室重构程度及收缩功能的评价提供了新的量化依据。Objective To evaluate the relationship among left ventricular vortex parameters and left ventricular remodeling and systolic function during isovolumic contraction time in patients with acute anterior myocardial infarction（AMI）by using vector flow mapping（VFM）. Methods Thirty-two patients who were clinically diagnosed as acute myocardial infarction（AMI） were enrolled in this study as case group. Their parameters such as heart size,systolic function and left ventricular sphericity index（SI） were measured. The parameters of vortex during isovolumic contraction time were measured and compared with the control group in VFM vortex imaging mode. Correlation analysis was done among the vortex intensity,the spherical index（SI）and left ventricular ejection fraction（EF%）during Isovolumic contraction time in patients with anterior myocardial infarction（AMI）. Results In the control group,during isovolumic contraction period the whole heart cavity filled with the whole vortex was formed. In the case group,there were local vortex in the main area such as the basal non-infarcted region and apical infarct area,and the vortex in the basal part was not significantly different from that in the control group（P〉0.05）. The apical vortex compared with the normal control group,Qmax decreased,the vortex core S increased,and VI decreased. Compared the vortex of the basal part with that of the apex,the Qmax was larger,the vortex core S was smaller,and the VI was larger（P〈0.05）. In the case group,the vortex intensity VI in the basal part was positively correlated with SI and EF in the left ventricle,but other parameters weren＇t correlated with them. Conclusion VFM provides a new quantitative basis for the evaluation of left ventricular remodeling degree and systolic function in patients with coronary heart disease of acute myocardial infarction from the perspective of fluid mechanics.

关 键 词：超声心动图描记术 心肌梗死 血流向量图 涡流 重构 收缩功能 血液流场 

分 类 号：R542.2[医药卫生—心血管疾病]