实时三维超声评价心肌梗死后左心室收缩功能及室壁运动同步性

发布时间：2018-02-21 04:49

本文关键词： 实时三维超声心动图心肌梗死心室功能左收缩功能同步性　出处：《中国医学影像技术》2015年04期 　论文类型：期刊论文

【摘要】：目的探讨实时三维超声心动图(RT-3DE)评价心肌梗死患者左心室收缩功能及同步性的应用价值。方法选取67例心肌梗死患者(心梗组)及61名健康志愿者(正常组)分别接受RT-3DE、M型超声及二维超声检查,心梗组分为3个亚组,A亚组:左冠状动脉狭窄(n=19)、B亚组:右冠状动脉狭窄(n=28),C亚组:多支病变(n=20)。分析比较3种方法所测以下参数:左心室整体、局部舒张末期容积(gEDV、rEDV),整体、局部收缩末期容积(gESV、rESV),整体、局部射血分数(gEF、rEF);左心室16节段从QRS波起点到最小收缩容积时间的标准差和最大差值(Tmsvl6-SD、Tmsvl6-Dif)。结果 M型超声、Simpson法所测的gEDV、gESV均高于RT-3DE(P均0.05)。以gEF55%作为判断收缩功能降低的截断点,M型超声、Simpson法、RT-3DE诊断心肌梗死的敏感度与特异度分别为96%和43%、98%和52%、98%和64%。RT-3DE局部心功能分析:与正常组对应节段比较,A亚组主要为前壁、前间隔,B亚组侧壁、下后壁、后间隔,C亚组绝大多数节段EDV、ESV增加,EF降低(P均0.05)。心梗组Tmsvl6-SD、Tmsvl6-Dif、Tmsvl6-SD%、Tmsvl6-Dif%均大于正常组(P均0.05)。结论 RT-3DE能更客观、准确地评价心肌梗死患者的收缩功能及室壁运动同步性,且能逐个节段进行局部定量分析,为临床提供更加全面可靠的参考信息。
[Abstract]:Objective to evaluate the value of real-time three-dimensional echocardiography (RT-3DE) in evaluating left ventricular systolic function and synchronism in patients with myocardial infarction. Methods 67 patients with myocardial infarction (MI group) and 61 healthy volunteers (normal group) were selected. Do not accept RT-3DEM-mode ultrasound and two-dimensional ultrasound examination, Myocardial infarction group was divided into 3 subgroups: left coronary artery stenosis group: left coronary artery stenosis group: right coronary artery stenosis subgroup C: multivessel lesion. Analysis and comparison of the following parameters measured by three methods: left ventricular whole, local end-diastolic volume: gEDVrEDV, whole, whole, and so on, the left ventricle, the left ventricle, the left ventricular end diastolic volume, the left ventricular end diastolic volume, the whole, the left ventricular stenosis, the right coronary artery stenosis, the right coronary artery stenosis and the right coronary artery stenosis. Local end-systolic volume / rESVN, whole, The standard deviation and maximum difference of left ventricular 16 segments from the beginning of QRS wave to the minimum systolic volume time were measured by Tmsvl6-SDT Tmsvl6-Difanf.Results the gEDV / gESV measured by M-mode ultrasound / Simpson method was higher than that of RT-3DE(P (0.05%). The sensitivity and specificity of RT-3DE in diagnosing myocardial infarction were 96% and 439.98% and 52.98% and 64.RT-3DE, respectively. In the anterior septal subgroup B subgroup, the majority of segmental EDV EDV ESV increased and EF decreased (P < 0.05). The Tmsvl6-SDV Tmsvl6-SDF Tmsvl6-SDF% in the myocardial infarction group was higher than that in the normal group (P < 0.05). Conclusion the RT-3DE is more objective, and it is more objective than that of the normal control group (P < 0.05), and the ratio of Tmsvl6-SDN to Tmsvl6-SDV is higher than that of the normal group (P < 0.05). The systolic function and the synchronism of ventricular wall motion in patients with myocardial infarction can be evaluated accurately, and the local quantitative analysis can be carried out one by one, which can provide more comprehensive and reliable reference information for clinical practice.
【作者单位】：青岛大学附属医院心脏超声科;
【分类号】：R445.1;R542.22

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