冠状动脉粥样硬化性心脏病和孤立性心房颤动患者心房结构及收缩功能的超声心动图评价  

Echocardiographic evaluation of atrial structure and systolic function in patients with coronary heart disease and paroxysmal atrial fibrillation

作　　者：郑嘉荣[1] 陈宣佑 高丽[1] 李晓静[1] 王冬[2] ZHENG Jiarong;CHEN Xuanyou;GAO Li;LI Xiaojing;WANG Dong(Department of Ultrasound,263 Clinical Department of Army General Hospital,Beijing 101149,China)

机构地区：[1]中国人民解放军陆军总院二六三临床部超声科,北京市101149 [2]重庆医科大学第一附属医院超声科

出　　处：《临床超声医学杂志》2018年第4期221-223,共3页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金项目(81571688)

摘　　要：目的探讨超声心动图在评价冠状动脉粥样硬化性心脏病(CHD)和孤立性心房颤动(PAF)患者心房增大的结构及功能改变中的应用价值。方法选取CHD和PAF患者各30例,另选健康体检者30例作为正常对照组,各组分别行超声心动图检查,记录左、右房左右径、前后径、上下径、容积(包括最大容积、最小容积及P波前容积)、主动射血分数、应变及应变率,并对其结果进行对比分析。结果 PAF组患者左、右房的左右径、前后径、上下径、容积均大于CHD组和正常对照组,主动射血分数、应变及应变率均小于CHD组和正常对照组,差异均有统计学意义(均P<0.05)。而CHD组患者左房前后径、上下径、左右径及容积均大于正常对照组,主动射血分数、应变及应变率均小于正常对照组,差异均有统计学意义(均P<0.05);CHD组右房上下径、左右径及主动射血分数与正常对照组比较差异均无统计学意义,而最大容积和P波前容积均大于正常对照组,应变和应变率均小于正常对照组,差异均有统计学意义(均P<0.05)。结论超声心动图可全面、准确地评价CHD和PAF患者心房结构及收缩功能的变化。CHD和PAF均可导致患者左、右房增大,且PAF造成的心房增大更显著。Objective To analyze the structural and functional changes of atrial enlargement in patients with coronary heart disease(CHD) and paroxysmal atrial fibrillation(PAF),and to investigate the application value of echocardiography in evaluating atrial structure and function.Methods Thirty patients with CHD,30 patients with PAF and 30 healthy volunteers as control group were enrolled. Echocardiography were performed on each group to record and compare the left and right atrial horizontal diameter,anteroposterior diameter,vertical diameter,volume(including maximum volume,minimum volume and P wave front volume),active ejection fraction,strain and strain rate.Results The left and right atrial horizontal diameter,anteroposterior diameter,vertical diameter and volume in PAF group were higher than those in CHD group and control group,while the active ejection fraction,strain and strain rate were lower than those in CHD group and control group,there were significant difference(all P<0.05). In CHD group,the anteroposterior diameter,vertical diameter,horizontal diameter and volume of left atrium were significantly higher than those in control group,while the active ejection fraction,strain and strain rate were lower than those in control group,there were significant difference(all P<0.05). In CHD group,the vertical and horizontal diameter of right atrium,and the active ejection fraction had no significant difference compared with control group,however,the maximum volume and P wave front volume were higher than those in control group,the strain and strain rate were lower than those in control group,there were significant difference(all P<0.05).Conclusion Echocardiography can accurately assess the changes of atrial structure and systolic function in patients with CHD and PAF.Both of CHD and PAF can lead to the enlargement of left atrium and right atrium,and the atrial enlargement caused by PAF is more significant.

关 键 词：超声心动描记术 冠状动脉粥样硬化性心脏病 心房颤动 孤立性 心房结构 功能 

分 类 号：R540.45[医药卫生—心血管疾病]