左心室声学造影评估房颤患者左室收缩功能的临床价值  

The Clinical Value for Left Ventricular Opacification in Assessment Left Ventricular Systolic Function in Patients with Atrial Fibrillation

作　　者：张琳堃 毛善永 陈婷婷 谷颖 张蓓 ZHANG Lingkun;MAO Shanyong;CHEN Tingting;GU Ying;ZHANG Bei(Department of Ultrasonic Center,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China)

机构地区：[1]贵州医科大学附属医院超声中心,贵州贵阳550004

出　　处：《贵州医科大学学报》2020年第8期963-966,972,共5页Journal of Guizhou Medical University

基　　金：贵州省科技厅联合基金[黔科合LH字(2016)7261号];博士基金(I-2017-16);贵州医科大学学术新苗基金[黔科合平台人才(2018)5779-36];国家自然科学基金(81960315);贵州省卫生计生委科学技术基金(gzwjkj2017-1-016);贵阳市科技局[筑科合同(2017)30-10];贵州省教育厅青年科技人才成长项目[黔教合KY字(2018)182]。

摘　　要：目的:探讨左心室声学造影(LVO)检测房颤患者左心收缩功能的临床价值。方法:根据纽约心脏病协会评估临床心功能分级标准(NYHA)将60例房颤患者分为心功能Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级组,所有患者分别采用二维常规超声(2D)及LVO方法检测患者的左心室舒张末期容积(EDV)、左心室收缩末期容积(ESV)和左心室射血分数(LVEF值),分析两种方法检测的3项指标的差异,评价LVEF值与NYHA分级的相关性。结果:NYHA分级的各组患者2D所测LVEF值较LVO检测LVEF值低,差异有统计学意义(P<0.05);Ⅲ、Ⅳ级NYHA分级患者2D超声所测EDV、ESV值较LVO所测的EDV、ESV高,差异有统计学意义(P<0.05);2D超声检测所得LVEF值与NYHA分级相关性R2值为0.591,LVO检测所得LVEF值与NYHA分级相关性分析R2值0.876。结论:LVO检查的LVEF值与NYHA相关性较好,该方法可以提高超声心动图对左室收缩功能检测的准确性。Objective:To assess the clinical value of left ventricular opacification(LVO)for the detection of left ventricular systolic function in patients with atrial fibrillation.Methods:Based on the the New York Heart Association(NYHA),60 patients with atrial fibrillation were divided into heart function groupsⅠ,Ⅱ,ⅢandⅣ.Left ventricular end-systolic volume(ESV),left ventricular enddiastolic volume(EDV)and left ventricular ejection fraction(LVEF)of all patients were detected by Simpson method with 2-dimensional conventional ultrasound(2 D)and LVO.The difference of LVEF with conventional ultrasound and LVO methods and the correlation between LVEF and NYHA were evaluated.Results:For all patients with atrial fibrillation in each NYHA group,there were statistical differences in LVEF detected by conventional ultrasound and LVO(P<0.05).The EDV and ESV detected with 2 D in GroupsⅢandⅣwere higher than those with LVO.The result was statistically different(P<0.05).The R^2 value of LVEF detected with 2 D and NYHA was 0.591,and the R^2 value of LVEF by LVO method and NYHA was 0.876.Conclusion:There is significant correlation in the test results of left ventricular systolic functions detected with 2 D and LVO in patients with atrial fibrillation.LVO can improve the accuracy of LVEF and it should be an important clinical detection method in the assessment of LVEF in patients with atrial fibrillation.

关 键 词：心房颤动 心室功能 左 左心室声学造影 纽约心功能分级 左心室射血分数 

分 类 号：R962[医药卫生—药理学]