实时三维超声心动图评价酒精性心肌病患者左右心室收缩功能的价值

发布时间：2018-04-10 17:02

本文选题：实时三维超声心动图 + 酒精性心肌病　；参考：《大连医科大学》2014年硕士论文

【摘要】：目的：应用实时三维超声心动图（RT-3DE）评价酒精性心肌病（ACM）患者左右心室收缩功能的价值。方法：ACM组30例：选取2010年2月～2012年11月于大连医科大学附属第二医院就诊的男性患者，每日饮啤酒≥4瓶（≥2200ml）或白酒≥150g（即纯乙醇125ml）10年以上，，符合酒精性心肌病标准，以上饮酒者均除外高血压、糖尿病、冠心病、心律失常、心脏瓣膜疾病、服用心脏药物或者可以影响心脏结构和功能变化的其他系统疾病；对照组30例，均为在本院体检的男性健康志愿者。对两组患者应用常规超声及RT-3DE对左右心室相关参数进行测定： 1.左心室的测量参数：常规超声参数包括左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）、左心室射血分数（LVEF）、左心室质量（LVM）、左心室质量指数（LVMI）；RT-3DE参数包括LVEDV、LVESV、LVEF、LVM、LVMI，以及通过RT-3DE得到的左心室容积-时间曲线计算得出参数Tmsv16-SD、Tmsv16-Dif、Tmsv16-SD/R-R(%)、Tmsv16-Dif/R-R(%)。将两组各参数进行统计学分析，同时与2DE法测值进行比较。 2.右心室的测量参数：2DE测量参数包括右心室舒张末期面积（RVEDA）和收缩末期面积（RVESA），计算右心室面积变化分数（RVFAC）；运用M型超声测量三尖瓣环收缩期位移（TAPSE）；RT-3DE测量参数包括右心室舒张末期容积（RVEDV）、收缩末期容积（RVESV）、每搏输出量（RVSV）、射血分数（RVEF）。比较上述参数两组间的差异，分析RVEF与RVFAC、TAPSE的相关性。结果： 1.左心室相关参数比较的结果：常规超声中，与对照组比较，ACM组的LVEDV、LVESV、LVM及LVMI均增高，LVEF减低，差异具有统计学意义（P0.05）。 RT-3DE中，与对照组比较，ACM组的LVEDV、LVESV、LVM及LVMI均增高，LVEF减低，差异具有统计学意义（P0.05）。ACM组Tmsv16-SD、Tmsv16-Dif、Tmsv16-SD/R-R(%)、Tmsv16-Dif/R-R(%)与对照组比较升高，差异均具有统计学意义（P均0.05）。 2DE与RT-3DE间相应参数比较：对照组中LVEDV、LVESV、LVEF、LVM及LVMI差异均无统计学意义（P均0.05）；ACM组中LVEDV、LVESV、LVM及LVMI差异均具有统计学意义（P均0.05），LVEF差异无统计学意义（P0.05）。 2.右心室相关参数比较的结果：常规超声中，ACM组RVEDA、RVESA与对照组比较增高，差异有统计学意义（P均0.05），ACM组RVFAC、TAPSE与对照组比较减低，差异有统计学意义（P均0.05）。 RT-3DE中，ACM组RVEDV、RVESV与对照组比较增高，差异有统计学意义（P均0.05），ACM组RVEF与对照组比较减低，差异有统计学意义（P0.05），ACM组RVSV与对照组比较无明显变化，差异无统计学意义（P0.05）。相关性分析，RVEF与RVFAC、TAPSE呈正相关（r=0.610、0.822，P均0.05）。结论： 1. RT-3DE可反映酒精性心肌病患者左心室结构及收缩功能异常和收缩不同步性，为临床诊断提供可靠依据。 2. RT-3DE能准确评价酒精性心肌病患者右心室收缩功能，具有一定的临床应用价值。
[Abstract]:Aim: to evaluate the left and right ventricular systolic function in patients with alcoholic cardiomyopathy (ACM) by real time three dimensional echocardiography (RT-3DE).All of the above drinkers except hypertension, diabetes, coronary heart disease, arrhythmia, heart valve disease, taking heart drugs or other systemic diseases which can affect the changes of heart structure and function.All of them were male healthy volunteers who were examined in our hospital.The parameters of left and right ventricle were measured by conventional ultrasound and RT-3DE in both groups.1.The parameters of Tmsv16-SDN Tmsv16-Difen Tmsv16-SDR-RN were calculated by the volume-time curve of left ventricle.The parameters of the two groups were statistically analyzed and compared with the values measured by 2DE method.2.The ventricular end-diastolic volume was RVEDVV, the end-systolic volume was RVESVV, the output volume per stroke was RVSVV, and the ejection fraction was RVEF.The differences between the above parameters were compared and the correlation between RVEF and RVFACTAPSE was analyzed.Results:1.Results of comparison of left ventricular parameters:Compared with the control group, the LVEDVV VVM and LVMI in the ACM group were higher and lower than those in the control group, and the difference was statistically significant (P 0.05).Comparison of the corresponding parameters between LVEDVV and RT-3DE: there was no significant difference in LVEDVV LVEFVM and LVMI in the control group. There was no significant difference in LVEDVV, LVESVV, LVM and LVMI between LVEDVV and LVEVV LVM and LVMI in the control group (P 0.05). There was no significant difference in LVEDVV, LVEV, LVM and LVMI between the two groups (P 0.05).2.The results of the comparison of the parameters of the right ventricle were as follows:RVFACTAPSE in ACM group was significantly lower than that in control group (P < 0.05).Compared with the control group, the RVEDVV RVESV in the RT-3DE group was higher than that in the control group, and the difference was statistically significant (P < 0.05). The RVEF in the ACM group was lower than that in the control group. The difference was statistically significant (P 0.05). There was no significant difference in RVSV between the ACM group and the control group, but there was no significant difference between the two groups (P 0.05).Conclusion:1.RT-3DE can reflect the abnormal structure and systolic function of left ventricle in patients with alcoholic cardiomyopathy, and provide reliable basis for clinical diagnosis.2.RT-3DE can accurately evaluate the right ventricular systolic function in patients with alcoholic cardiomyopathy.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R542.2;R540.45

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