本文選題：心力衰竭　切入點(diǎn)：肺高壓　出處：《中國(guó)醫(yī)學(xué)影像技術(shù)》2016年05期 　論文類(lèi)型：期刊論文

【摘要】：目的采用單心動(dòng)周期實(shí)時(shí)三維超聲心動(dòng)圖(sRT-3DE)結(jié)合傳統(tǒng)二維超聲心動(dòng)圖探討左心室射血分?jǐn)?shù)(LVEF)減低的左心力衰竭患者肺高壓(PH)對(duì)右心室重構(gòu)的影響。方法對(duì)sRT-3DE檢查L(zhǎng)VEF50%的60例患者(病例組)根據(jù)肺動(dòng)脈收縮壓(PASP)及肺血管阻力(PVR)不同分為3個(gè)亞組:HF-NPH亞組15例,HF-PPH亞組15例,HF-RPH亞組30例,正常健康人35名為對(duì)照組。對(duì)兩組行常規(guī)二維超聲及sRT-3DE檢查,分析獲得三維、二維及多普勒超聲參數(shù),進(jìn)行組間對(duì)比分析和相關(guān)性分析。結(jié)果與對(duì)照組比較:病例組右心室舒張末期容積指數(shù)(EDVI)、收縮末期容積指數(shù)(ESVI)、基底部橫徑(D1)、長(zhǎng)徑(LD)、D1/中間橫部徑(D2)、射血分?jǐn)?shù)(EF)減小。與HF-NPH亞組比較,HF-PPH亞組右心室ESVI、D1/D2、LD/D2增大。與HF-PPH亞組比較,HF-RPH亞組右心室EDVI、ESVI、D2增大,右心室EF、LD/D2減低。PVR與PASP、右心室EF與左心室EF、右心室LD與左心室LD呈正相關(guān)性(r=0.765、0.628、0.725;P均0.01),PVR與右心室EF呈負(fù)相關(guān)(r=-0.715,P0.01),且高于與PASP的相關(guān)性(r=-0.623,P0.01)。結(jié)論 sRT-3DE結(jié)合傳統(tǒng)二維及多普勒超聲可準(zhǔn)確評(píng)估左心力衰竭患者的右心室重構(gòu),有助于判斷右心室結(jié)構(gòu)和功能狀態(tài)。
[Abstract]:Objective to investigate the effect of left ventricular ejection fraction (LVEF) on right ventricular remodeling in patients with left heart failure by single cycle real-time three-dimensional echocardiography (RT-3DED) combined with traditional two-dimensional echocardiography. Methods sRT-3DE was performed in patients with left heart failure. According to pulmonary arterial systolic pressure (PASP) and pulmonary vascular resistance (PVR), 60 patients (LVEF 50%) were divided into 3 subgroups: 15 cases of HF-PPH subgroup, 15 cases of HF-PPH subgroup, 30 cases of HF-RPH subgroup. 35 healthy persons were used as control group. The parameters of three-dimensional, two-dimensional and Doppler ultrasound were obtained by routine two-dimensional ultrasound and sRT-3DE examination in both groups. Results compared with the control group, the right ventricular end-diastolic volume index (EDVI), the end-systolic volume index (ESVI), the basal transverse diameter (D _ 1), the long diameter (D _ (1)), the middle transverse diameter (D _ (2)) and the ejection fraction (EF) were decreased in the case group. Compared with the HF-NPH subgroup, the right ventricular ESVII D 1 / D 2 D 2 increased in the HF-PPH subgroup, and the right ventricular EDV I I D 2 increased in the HF-RPH subgroup compared with the HF-PPH subgroup. LDR / D2 of right ventricle decreased. PVR and PASP, EF of right ventricle and EFF of left ventricle, LD of right ventricle were positively correlated with LD of left ventricle. Sound can accurately evaluate the right ventricular remodeling in patients with left heart failure. It is helpful to judge the structure and function of right ventricle.
【作者單位】： 中國(guó)醫(yī)科大學(xué)附屬第一醫(yī)院心血管超聲科;
【基金】：高等學(xué)校博士學(xué)科點(diǎn)專(zhuān)項(xiàng)基金(20112104110010) 沈陽(yáng)市科技攻關(guān)項(xiàng)目(F12-193-9-19)
【分類(lèi)號(hào)】：R540.45;R541.6

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