發(fā)布時(shí)間：2018-03-17 18:20

  本文選題：心室功能　切入點(diǎn)：超聲心動(dòng)描記術(shù)　出處：《中國(guó)循環(huán)雜志》2017年03期 　論文類型：期刊論文

【摘要】：目的:應(yīng)用雙脈沖多普勒超聲心動(dòng)圖技術(shù)觀察健康人群中左、右心室收縮期及舒張期機(jī)械做功的順序。方法:選取100例健康志愿者,分別取雙流出道切面和心尖四腔切面,應(yīng)用雙脈沖多普勒技術(shù)在同一心動(dòng)周期同步記錄左心室流出道、右心室流出道血流頻譜和左心室流入道、右心室流入道血流頻譜,分別測(cè)量心電圖QRS波群頂點(diǎn)至主動(dòng)脈、肺動(dòng)脈、二尖瓣和三尖瓣血流頻譜起始的時(shí)間間期,計(jì)算主動(dòng)脈和肺動(dòng)脈血流頻譜、二尖瓣和三尖瓣血流頻譜起始時(shí)間的差值,進(jìn)而評(píng)估左、右心室收縮和舒張機(jī)械做功的順序。結(jié)果:48例左心室先于右心室射血,占48%(95%CI:0.38~0.58);46例右心室先于左心室射血,占46%(95%CI:0.36~0.56);6例左、右心室同時(shí)射血,占6%(95%CI:0.01~0.11)。96例右心室先于左心室充盈,占96%(95%CI:0.90~0.99);3例左心室先于右心室充盈,占3%(95%CI:0.01~0.08);1例左、右心室同時(shí)充盈,占1%(95%CI:0.00~0.05)。結(jié)論:健康人群的左、右心室收縮期及舒張期做功順序,具有一定的規(guī)律:收縮期做功順序因人而異,但舒張期做功順序,右心室始終在前。根據(jù)正常狀態(tài)下心室間機(jī)械做功的順序優(yōu)化起搏器程控參數(shù),選擇優(yōu)化舒張期心臟做功順序,可能是未來心臟再同步治療(CRT)起搏器參數(shù)優(yōu)化的終點(diǎn)指標(biāo)。
[Abstract]:Objective: to observe the order of left and right ventricular systolic and diastolic mechanical work in healthy subjects by double pulse Doppler echocardiography. The flow spectrum of left ventricular outflow tract, right ventricular outflow tract, left ventricular inflow tract and right ventricular inflow tract were recorded simultaneously by dual-pulse Doppler technique in the same cardiac cycle. The peak of QRS wave group to aorta were measured respectively. The time interval between the onset of pulmonary artery, mitral and tricuspid flow spectra, the difference between aortic and pulmonary blood flow spectrum, mitral and tricuspid flow spectrum initiation time, and further evaluation of left, Results the order of mechanical work of right ventricular contraction and relaxation. Results: 48 cases of left ventricle ejected before right ventricle, accounting for 48% 95 CI: 0.38% 0.58% and 46 cases of right ventricle before left ventricular ejection, accounting for 4695% I 0.36% 0.56%, 6 cases left, right ventricular simultaneous ejection, accounting for 69 95 CI: 0.01 0. 11% 0.11%. 96 cases of right ventricle filled up in front of left ventricle. 3 cases with left ventricle filling ahead of right ventricle, 3 cases with left ventricle filling before right ventricle, 1 case with left ventricle and 1 case with right ventricle filling at the same time, 1 case with right ventricle filling at the same time. Conclusion: the order of left and right ventricular systolic and diastolic work of healthy people has a certain rule: the order of doing work in systolic period is different from person to person. But the order of diastolic work, right ventricle is always in front. According to the order of mechanical work done between ventricles in normal state, the program control parameters of pacemaker are optimized, and the order of doing work in diastolic heart is optimized. It may be an end point for the optimization of pacemaker parameters in future cardiac resynchronization therapy (CRT).
【作者單位】： 北京大學(xué)人民醫(yī)院心臟中心;復(fù)旦大學(xué)附屬中山醫(yī)院心臟超聲診斷科;
【分類號(hào)】：R540.45

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