超声心动图三维重建对病毒性心肌炎和扩张型心肌病左心功能的研究  

The study of left ventricular function of viral myocarditis and dilated cardiomyopathy with three - dimensional echocardiography

作　　者：徐大地[1] 陆颖静[1] 吴明漪[1] 陈秀玉[1] 徐慧源[1] 

机构地区：[1]上海市儿童医院,200040

出　　处：《上海医学影像》1999年第3期101-103,共3页Shanghai Medical Imaging

摘　　要：目的 探讨超声心动图三维重建(3DE)在左心功能方面的应用价值。方法 共计重建了25个心脏的三维结构。其中正常组10例,病毒性心肌炎组(简称心肌炎组)10例和扩张型心肌病组(简称心肌病组)5例。左心功能指标为M型超声(ME)的左室射血分数(EF)和左室短轴缩短率(FS),二维超声(2DE)和3DE的EF和左室每搏输出量(SV)。结果 因用3DE重建图象来计算心脏容积等参数时无需进行任何假设,故能获得更直观和精确的左室容量信息。结论 本文认为:1.习惯上应用的EF正常值(≥60％)偏大,建议改为>50％为宜;2.超声在ME、2DE和3DE三种方法对心肌炎组EF测值的对比中以3DE法最敏感(P<0.01),建议临床上可将3DE的EP测值作为对心肌炎左心功能评价的参考指标之一;3.超声三种方法对心肌病的EF测值都极敏感(P<0.01),且三者间无显著性差异。Purpose To study the clinical application of three - dimensional echocardiography(3DE)on the. left ventricular function. Methods Three - dimensional structures of 25 hearts were reconstructed including normal group in 10, viral myocarditis in 10 , and dilated cardiomyopathy (DCM) in 5.The parameters of LV function included ejection fraction (EF)and shortening fraction (FS)of LV in M- mode echocardiography(ME), EF and stroke volume(SV)of LV in two- dimensional echocardiography(2DE)and 3DE. Results More direct and accurate LV function informations were obtained by 3DE calculation,because not any assumption was needed. Conclusion 1. Considering that the normal value of EF≥60% traditionally used was somewhat too high , we suggest it could be better to change it to > 50% ;2. Comparing the EF values of myocarditis from ME,2DE and 3DE and finding 3DE was the most sensitive (p < 0.01), we suggest the value of 3DE could be a useful value in appraising the LV function of viral myocarditis; 3. All the EF values of the three echographic methods were extremely sensitive (p < 0.01) for DCM, and no significant diffrences were present among them.

关 键 词：三维超声心动图 病毒性心肌炎 扩张型心肌病 左心功能 3DE 心血管疾病 

分 类 号：R542.2[医药卫生—心血管疾病] R540.45[医药卫生—内科学]