室壁节段性运动异常与冠状动脉疾病解剖学变化特点的超声研究  

Echocardiographic study on anatomic changes of regional wall motion abnormality with coronary artery disease

作　　者：黄小琴[1] 万晓荆[1] 丁桂春[1] 简文豪[1] 刘梅[1] 张轻[1] 

机构地区：[1]北京军区总医院超声科,100700

出　　处：《中华超声影像学杂志》2004年第2期85-87,共3页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金委资助 ( 39970 71 0 )

摘　　要：目的　应用超声心动图探讨室壁节段性运动异常对冠状动脉疾病心脏解剖结构的影响 ,以及对疾病严重程度的认定。方法　受检对象共 12 5例。冠状动脉疾病组 63例 (其中普通患者 41例 ,急性心肌梗死 7例 ,陈旧性心肌梗死 15例 ) ,全部病例分别经临床冠状动脉搭桥术、球囊扩张并支架安放术、冠脉造影及放射性核素扫描证实 ;正常对照组 62例。二维超声选用标准的左室短轴和长轴观声像图 ,显示室壁节段性运动异常构成心室整体的向心性非协调性运动和非向心性矛盾样运动 ;运用M型超声连续扫查观察室壁节段性运动异常的典型特征。结果　 63例冠状动脉疾病患者中的 43例 (68.2 % )显示为单发室壁节段性运动异常 ,2 0例 (3 1.8% )则显示为多发室壁节段性运动异常 (P <0 .0 1)。所有患者左室室壁节段性运动异常局部心内膜均显现回声增强 ,收缩运动幅度减低 ,舒张速度减慢。室壁节段性运动异常无论单发或多发 ,均被二维和M型超声清晰显示。 58例合并心房扩大 ,单纯左房扩大者 3 9例。发生心肌梗死的 2 2例重症患者中 ,有 17例合并左、右心室不同程度的扩大。ObjectiveTo investigate the influence of r egional wall motion abnormality(RWMA) on cardiac anatomic structure with coronary artery disease (CAD) and to recognize serious degree of the disease by echocardiography. MethodsA total of 125 cases was observed. There were 63 patients in CAD group (41 cases with general CAD,7 cases with acute myocardial infarction and 15 cases with old myocardial infarction). All the patients had undergone respectively CABG,PTCA and stent,coronary angiography or radionuclide scan for confirmation. There were 62 cases in normal control group. Using 2D echocardiography,stand short and long axis images of left ventricle(LV) were chosen. Displayed RWMA to compose the centripetal disharmonized motion with whole-wall of LV,and the discentripetal contradiction motion. M mode for continuous scan was to detect the typical characterisitic of RWMA. ResultsSingle-occurring RWMA from 43 cases ( 68.2 %) in 63 cases with CAD was displayed, while multiple-occurring RWMA from another 20 cases ( 31.8 %) was displayed(P< 0.01 ). In all the patients, the echo increased,the systolic amplitude decreased,the diastolic velocity was lower than that of the normal,from regional of RWMA. No matter whether it was single-occurring or multiple-occurring RWMA,all were shown clearly by 2D and M mode echocardiography. The atrium was larger in 58 cases of all,only left ventricular diamerer was larger in 39 cases of them. Left ventircular diameter and right ventircular diameter were increased in 17 serious cases of 22 patients with myocardial infarction. Conclusions Non-injury echocardiography provides objective diagnostic value on characteristic anatomic changes due to RWMA and serious degree of CAD.

关 键 词：室壁节段性运动异常 冠状动脉疾病 解剖学 诊断 超声心动图 

分 类 号：R445.1[医药卫生—影像医学与核医学]