超声心动图评价缺血性心脏病左心室收缩同步性和心功能变化  

Using ultrasonic cardiogram to evaluate left ventricular systolic synchrony and cardiac function in ischemic heart disease patients

作　　者：马润锋 MA Runfeng(Department of Internal Medicine,the People's Hospital of Baiyun District,Guangzhou 510500,China)

机构地区：[1]广州市白云区人民医院内一科,广东广州510500

出　　处：《中国医学物理学杂志》2019年第3期330-333,共4页Chinese Journal of Medical Physics

摘　　要：目的:研究超声心动图评价缺血性心脏病患者左心室收缩同步性和心功能变化。方法:连续选择84例缺血性心脏病患者,其中无症状性心力衰竭28例,轻中度心力衰竭40例,重度及难治性心力衰竭16例。采用超声心动图评价室间同步性,以室间机械延迟(IVMD)表示,室内收缩同步性以收缩达峰时间标准差(Ts-SD)表示;心功能指标包括左室射血分数(LVEF)、左室舒张末内径(LVEDd)、B型利钠肽(BNP)和QRS波时限。结果:IVMD、Ts-SD和QRS波时限随心衰加重逐渐升高,差异有统计学意义(P<0.05)。3组间QRS波时限≥120 ms比例比较无差异(P=0.593),各组QRS波时限≥120 ms较<120 ms患者的IVMD、Ts-SD、LVEDd和BNP水平升高,LVEF水平降低,差异有统计学意义(P<0.05)。结论:缺血性心脏病不同程度患者的左心室收缩同步性不同,需结合心功能进行综合评估。Objective To study left ventricular systolic synchrony and cardiac function in ischemic heart disease patients with ultrasonic cardiogram. Methods A total of 80 patients with ischemic heart diseases were enrolled, including 28 cases of silent heart failure, 40 of mild to moderate heart failure and 16 of severe and refractory heart failure. Ultrasonic cardiogram was used to evaluate interventricular synchrony with interventricular mechanical delay (IVMD) and intraventricular systolic synchrony with standard deviation of the time to peak systolic velocity (Ts-SD). The evaluated cardiac function indicators included left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDd), type B natriuretic peptide (BNP), and QRS duration. Results The values of IVMD, Ts-SD and QRS duration were gradually increased as heart failure aggravated (P<0.05). No statistical difference was found in the proportion of QRS duration ≥120 ms among 3 groups (P=0.593). Compared with those in patients with QRS duration <120 ms, the values of IVMD, Ts-SD, LVEDd and BNP were all significantly higher, while LVEF level was lower in patients with QRS duration ≥120 ms, with statistical differences (P<0.05). Conclusion The left ventricular systolic synchrony in patients with varying degrees of ischemic heart disease is different, Therefore a comprehensively evaluation considering cardiac functions is necessary.

关 键 词：超声心动图 缺血性心脏病 心室收缩同步性 心功能 

分 类 号：R541[医药卫生—心血管疾病]