实时三维超声心动图联合三维斑点追踪技术对心肌梗死后心力衰竭患者右心功能的评估价值  

Real-time three-dimensional echocardiography combined three dimensional spot tracking technology of right heart function in patients with heart failure after myocardial infarction assessment

作　　者：杨晓青 王立美 王紫韫 王晓辉 李洁[1] 王小颖 Yang Xiaoqing;Wang Limei;Wang Ziyun;Wang Xiaohui;Li Jie;Wang Xiaoying(Department of Ultrasound,Shijiazhuang People’s Hospital,Hebei Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市人民医院超声科,河北石家庄050011

出　　处：《中国医刊》2022年第12期1321-1325,共5页Chinese Journal of Medicine

基　　金：河北省医学科学研究课题(20201415)。

摘　　要：目的 探讨实时三维超声心动图联合三维斑点追踪技术对心肌梗死后心力衰竭患者右心功能的评估价值。方法 选取2020年6月至2021年5月在河北省石家庄市人民医院住院治疗的心肌梗死后心力衰竭患者102例作为观察组,并根据纽约心脏病协会心功能分级标准分为心功能Ⅱ级组、心功能Ⅲ级组和心功能Ⅳ级组3个亚组,另选取同期健康体检的成人100例作为对照组,采用组织多普勒超声、三维斑点追踪及实时三维超声心动图对两组受试者进行右心功能分析。结果 对照组与观察组的年龄、性别、体重、身高差异均无显著性(P>0.05),观察组吸烟、饮酒的比例显著高于对照组(P<0.05)。观察组各亚组三尖瓣环收缩期位移明显低于对照组,且心功能Ⅳ级组明显低于心功能Ⅱ级组和Ⅲ级组,差异均有显著性(P<0.05);观察组各亚组室间隔Tei指数和右心室游离壁三尖瓣环Tei指数明显高于对照组,且心功能Ⅳ级组明显高于心功能Ⅱ级组和Ⅲ级组,心功能Ⅲ级组明显高于心功能Ⅱ级组,差异均有显著性(P<0.05)。对照组、心功能Ⅱ级组和Ⅲ级组右心室舒张末期容积、右心室收缩末期容积、右心室每搏量比较差异均无显著性(P>0.05),但三组右心室舒张末期容积、右心室收缩末期容积均明显低于心功能Ⅳ级组,右心室每搏量明显高于心功能Ⅳ级组,差异有显著性(P<0.05)。相关分析显示,右心室射血分数和Em/Am与心功能分级显著相关,且随心功能恶化而降低(P<0.05)。右心室间隔纵向应变及右心室游离壁纵向应变对照组及观察组各亚组间比较差异均有显著性,且随心功能恶化而降低(P<0.05)。结论 采用实时三维超声心动图联合三维斑点追踪技术评估心肌梗死后心力衰竭患者的右心功能有助于早期了解病情变化,提高诊疗水平,改善患者预后。Objective To investigate the value of real-time three-dimensional echocardiography combined with three-dimensional speckle tracking in evaluating right ventricular function in patients with heart failure after myocardial infarction. Method A total of 102 patients with heart failure after myocardial infarction hospitalized in Shijiazhuang People’s Hospital from June 2020 to May 2021 were selected as the observation group. According to the heart function grading standard of New York Heart Association, the observation group was divided into three subgroups: heart function grade Ⅱgroup, heart function grade Ⅲ group and heart function grade Ⅳ. Another 100adults in the same period were selected as the control group. The right heart function of the two groups was analyzed by tissue Doppler echocardiography, three-dimensional speckle tracking and real-time three-dimensional echocardiography. Result There was no significant difference in age, sex, weight and height between the control group and the observation group(P>0.05). The proportion of smoking and drinking in the observation group was significantly higher than that in the control group(P<0.05). The systolic displacement of tricuspid annulus in each subgroup of the observation group was significantly lower than that in the control group, and the cardiac function in the Ⅳ group was significantly lower than that in the grade Ⅱand Ⅲ groups(P<0.05). The Tei index of interventricular septum and the Tei index of tricuspid annulus of right ventricular free wall in the observation group were significantly higher than those in the control group.In addition, the cardiac function of grade Ⅳgroup was significantly higher than that of gradeⅡgroup and grade Ⅲ group, and the cardiac function of grade Ⅲ group was significantly higher than that of grade Ⅱ group(P<0.05). There was no significant difference in right ventricular end diastolic volume, right ventricular end systolic volume and right ventricular stroke volume among the control group, cardiac functi

关 键 词：三维超声心动图 心肌梗死 心力衰竭 三维斑点追踪技术 右心功能 

分 类 号：R542.2[医药卫生—心血管疾病]