發(fā)布時(shí)間：2018-04-10 17:02

  本文選題：實(shí)時(shí)三維超聲心動(dòng)圖 + 酒精性心肌病��； 參考：《大連醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：應(yīng)用實(shí)時(shí)三維超聲心動(dòng)圖（RT-3DE）評價(jià)酒精性心肌�。ˋCM）患者左右心室收縮功能的價(jià)值。 方法：ACM組30例：選取2010年2月～2012年11月于大連醫(yī)科大學(xué)附屬第二醫(yī)院就診的男性患者，每日飲啤酒≥4瓶（≥2200ml）或白酒≥150g（即純乙醇125ml）10年以上，，符合酒精性心肌病標(biāo)準(zhǔn)，以上飲酒者均除外高血壓、糖尿病、冠心病、心律失常、心臟瓣膜疾病、服用心臟藥物或者可以影響心臟結(jié)構(gòu)和功能變化的其他系統(tǒng)疾��；對照組30例，均為在本院體檢的男性健康志愿者。對兩組患者應(yīng)用常規(guī)超聲及RT-3DE對左右心室相關(guān)參數(shù)進(jìn)行測定： 1.左心室的測量參數(shù)：常規(guī)超聲參數(shù)包括左心室舒張末期容積（LVEDV）、左心室收縮末期容積（LVESV）、左心室射血分?jǐn)?shù)（LVEF）、左心室質(zhì)量（LVM）、左心室質(zhì)量指數(shù)（LVMI）；RT-3DE參數(shù)包括LVEDV、LVESV、LVEF、LVM、LVMI，以及通過RT-3DE得到的左心室容積-時(shí)間曲線計(jì)算得出參數(shù)Tmsv16-SD、Tmsv16-Dif、Tmsv16-SD/R-R(%)、Tmsv16-Dif/R-R(%)。將兩組各參數(shù)進(jìn)行統(tǒng)計(jì)學(xué)分析，同時(shí)與2DE法測值進(jìn)行比較。 2.右心室的測量參數(shù)：2DE測量參數(shù)包括右心室舒張末期面積（RVEDA）和收縮末期面積（RVESA），計(jì)算右心室面積變化分?jǐn)?shù)（RVFAC）；運(yùn)用M型超聲測量三尖瓣環(huán)收縮期位移（TAPSE）；RT-3DE測量參數(shù)包括右心室舒張末期容積（RVEDV）、收縮末期容積（RVESV）、每搏輸出量（RVSV）、射血分?jǐn)?shù)（RVEF）。比較上述參數(shù)兩組間的差異，分析RVEF與RVFAC、TAPSE的相關(guān)性。 結(jié)果： 1.左心室相關(guān)參數(shù)比較的結(jié)果： 常規(guī)超聲中，與對照組比較，ACM組的LVEDV、LVESV、LVM及LVMI均增高，LVEF減低，差異具有統(tǒng)計(jì)學(xué)意義（P0.05）。 RT-3DE中，與對照組比較，ACM組的LVEDV、LVESV、LVM及LVMI均增高，LVEF減低，差異具有統(tǒng)計(jì)學(xué)意義（P0.05）。ACM組Tmsv16-SD、Tmsv16-Dif、Tmsv16-SD/R-R(%)、Tmsv16-Dif/R-R(%)與對照組比較升高，差異均具有統(tǒng)計(jì)學(xué)意義（P均0.05）。 2DE與RT-3DE間相應(yīng)參數(shù)比較：對照組中LVEDV、LVESV、LVEF、LVM及LVMI差異均無統(tǒng)計(jì)學(xué)意義（P均0.05）；ACM組中LVEDV、LVESV、LVM及LVMI差異均具有統(tǒng)計(jì)學(xué)意義（P均0.05），LVEF差異無統(tǒng)計(jì)學(xué)意義（P0.05）。 2.右心室相關(guān)參數(shù)比較的結(jié)果： 常規(guī)超聲中，ACM組RVEDA、RVESA與對照組比較增高，差異有統(tǒng)計(jì)學(xué)意義（P均0.05），ACM組RVFAC、TAPSE與對照組比較減低，差異有統(tǒng)計(jì)學(xué)意義（P均0.05）。 RT-3DE中，ACM組RVEDV、RVESV與對照組比較增高，差異有統(tǒng)計(jì)學(xué)意義（P均0.05），ACM組RVEF與對照組比較減低，差異有統(tǒng)計(jì)學(xué)意義（P0.05），ACM組RVSV與對照組比較無明顯變化，差異無統(tǒng)計(jì)學(xué)意義（P0.05）。 相關(guān)性分析，RVEF與RVFAC、TAPSE呈正相關(guān)（r=0.610、0.822，P均0.05）。 結(jié)論： 1. RT-3DE可反映酒精性心肌病患者左心室結(jié)構(gòu)及收縮功能異常和收縮不同步性，為臨床診斷提供可靠依據(jù)。 2. RT-3DE能準(zhǔn)確評價(jià)酒精性心肌病患者右心室收縮功能，具有一定的臨床應(yīng)用價(jià)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.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R542.2;R540.45

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