不同类型完全性左束支传导阻滞患者心室功能与心室内收缩同步性的差异  

The Differences in Ventricular Function and Ventricular Systolic Synchrony in Patients with Different Types of Complete Left Bundle Branch Block

作　　者：刘艳 陈小春 郑建民 Liu Yan;Chen Xiaochun;Zheng Jianmin(Jiaocheng District Hospital,Ningde City,Fujian Province,Ningde Fujian 352100,China)

机构地区：[1]福建省宁德市蕉城区医院,福建宁德352100

出　　处：《医疗装备》2024年第21期19-23,共5页Medical Equipment

摘　　要：目的评估不同类型完全性左束支传导阻滞(CLBBB)患者心室功能、心室内收缩同步性的差异。方法采用回顾性研究,将2021年2月至2023年12月医院收治的85例CLBBB患者作为试验组,将同期进行体检的50名健康人为对照组。两组均采用常规超声检查左心房前后径(LAD)、左心室舒张末期内径(LVEDD)、左心室舒张末期容积(LVEDV)、左心室射血分数(LVEF)、三尖瓣环收缩期位移(TAPSE)及右心室面积变化率(RVFAC),并采用二维斑点追踪成像技术(2D-STI)测量左心室整体纵向峰值应变(LVGLS)、右心室整体纵向峰值应变(RVGLS)及应变达峰时间的标准差。比较两组的心室功能指标(LAD、LVEDD、LVEDV、LVEF、TAPSE、RVFAC)、心室内收缩同步性指标(LVGLS、RVGLS);根据左心室后室间隔纵向时间-应变曲线将试验组分为Ⅰ、Ⅱ、Ⅲ型,比较不同分型CLBBB患者的心室功能指标、心室收缩同步性指标。结果试验组LAD、LVEDD、LVEDV、应变达峰时间的标准差均高于对照组,LVEF、TAPSE、RVFAC及LVGLS和RVGLS的绝对值均低于对照组,差异有统计学意义(P<0.05)。Ⅰ、Ⅱ、Ⅲ型CLBBB患者的LAD、LVEDD、LVEDV、应变达峰时间的标准差呈递增趋势,LVEF、TAPSE及LVGLS和RVGLS的绝对值呈递减趋势,差异均有统计学意义(P<0.05);RVFAC呈递减趋势,但差异无统计学意义(P>0.05)。结论Ⅰ、Ⅱ型CLBBB患者的心室功能优于Ⅲ型,Ⅲ型CLBBB患者的左心室内收缩不同步性较Ⅰ、Ⅱ型CLBBB患者显著。Objective To evaluate the differences of ventricular function and ventricular systolic synchrony in patients with different types of complete left bundle branch block(CLBBB).Methods Adopting a retrospective study,with 85 CLBBB patients admitted to the hospital from February 2021 to December 2023 as the experimental group,and 50 healthy individuals who underwent physical examinations during the same period as the control group,in both groups,conventional ultrasound was used to examine left atrial diameter(LAD),left ventricular end diastolic dimension(LVEDD),left ventricular end diastolic volume(LVEDV),left ventricular ejection fraction(LVEF),tricuspid annular plane systolic excursion(TAPSE),and right ventricular fractional area change(RVFAC).In addition,two-dimensional speckle tracking imaging(2D-STI)technology was used to measure the left ventricular global longitudinal strain(LVGLS),the right ventricular global longitudinal strain(RVGLS),and the standard deviation of strain peak time.The ventricular function indicators(LAD,LVEDD,LVEDV,LVEF,TAPSE,RVFAC)and ventricular systolic synchrony indicators(LVGLS,RVGLS)between the two groups were compared;According to the longitudinal time-strain curve of the left ventricular posterior interventricular septum,the experimental groups were divided into typesⅠ,Ⅱ,andⅢ,and the ventricular function indicators and ventricular systolic synchrony indicators of CLBBB patients with different subtypes were compared.Results The LAD,LVEDD,LVEDV,and standard deviations of strain peak time in the experimental group were higher than those in the control group,while the absolute values of LVEF,TAPSE,RVFAC,LVGLS,and RVGLS were lower than those in the control group,and the differences were statistically significant(P<0.05).The LAD,LVEDD,LVEDV,and standard deviations of strain peak time in patients with typeⅠ,Ⅱ,andⅢCLBBB showed an increasing trend,while the absolute values of LVEF,TAPSE,LVGLS,and RVGLS showed a decreasing trend,with statistically significant differences(P<0.05);RVF

关 键 词：完全性左束支传导阻滞 心室功能 心室内收缩同步性 二维斑点追踪成像技术 

分 类 号：R541.4[医药卫生—心血管疾病]