發(fā)布時間：2018-05-24 02:24

  本文選題：超聲心動描記術(shù) + Tei指數(shù)��； 參考：《河北聯(lián)合大學》2014年碩士論文

【摘要】：目的利用脈沖多普勒和組織多普勒兩種方法測定計算左室舒張功能減低患者及正常對照者的心肌運動指數(shù)（Tei指數(shù)），分析兩種Tei指數(shù)的一致性，并探討Tei指數(shù)評估左室舒張功能的價值。 方法將140例臨床明確診斷的左室舒張功能減低的患者作為病例組，依據(jù)超聲心動圖脈沖多普勒二尖瓣血流頻譜E/A比值及組織多普勒二尖瓣環(huán)運動速度指標Ea/Aa比值分為中度左室舒張功能減低組（A組）和輕度左室舒張功能減低組（B組）。A組：1E/A2，Ea/Aa 1；B組：E/A 1，，Ea/Aa 1。選取同期進行健康體檢，并且年齡、性別與病例組相匹配的80例健康者作為對照組（C組）。所有研究對象經(jīng)常規(guī)超聲心動圖檢查后，利用脈沖多普勒二尖瓣和主動脈瓣的血流頻譜測定計算脈沖多普勒Tei指數(shù)；組織多普勒成像（TDI）模式下，測量二尖瓣環(huán)間隔、側(cè)壁兩個位點運動頻譜的Ea、Aa速度峰值，計算Ea/Aa比值，以上述兩個位點的平均Ea、Aa代替二尖瓣環(huán)的整體運動速度指標，同時分別測定計算該二個位點的TDI Tei指數(shù)，并計算兩個TDI Tei指數(shù)的平均值。 結(jié)果1中度左室舒張功能減低組（A組）、輕度左室舒張功能減低組（B組）、正常對照組（C組）的脈沖多普勒Tei指數(shù)[（0.54±0.06）vs（0.46±0.07）vs（0.36±0.06）]、側(cè)壁TDI Tei指數(shù)[（0.54±0.06）vs（0.46±0.07）vs（0.36±0.06）]、間隔TDI Tei指數(shù)[（0.56±0.06）vs（0.48±0.07）vs（0.38±0.06）]、平均TDI Tei指數(shù)[（0.55±0.06）vs（0.47±0.07）vs（0.37±0.06）]相比較，差異均有統(tǒng)計學意義（P0.01）。2脈沖多普勒Tei指數(shù)與LVEF、E峰、Ea/Aa呈負相關(guān)（rs=－0.29/－0.23/－0.57，均P0.01），與Aa、E/Ea呈正相關(guān)（rs=0.30/0.56，均P0.01）。3兩種方法所測Tei指數(shù)高度相關(guān)；Bland-Altman法顯示脈沖Tei指數(shù)與TDI Tei指數(shù)一致性良好。4Tei指數(shù)鑒別左室舒張功能減低的敏感性及特異性均較高。脈沖多普勒Tei指數(shù)ROC曲線下面積0.921，以脈沖Tei指數(shù)≥0.455作為鑒別左室舒張功能異常的臨界點，敏感性為76.7%，特異性為98.7%；側(cè)壁TDI Tei指數(shù)ROC曲線下面積0.923，以側(cè)壁TDI Tei指數(shù)≥0.443作為鑒別左室舒張功能異常的臨界點，敏感性為78.6%，特異性為98.7%。 結(jié)論脈沖多普勒Tei指數(shù)與組織多普勒Tei指數(shù)具有良好的一致性。Tei指數(shù)隨舒張功能降低程度的加重呈線性增大趨勢，與常規(guī)超聲左心功能參數(shù)有一定的相關(guān)性，對左室舒張功能異常具有較高的診斷價值。TDI Tei指數(shù)精度高，測量簡捷，更值得臨床推廣應用。
[Abstract]:Objective to determine and analyze the consistency of left ventricular diastolic dysfunction in patients with left ventricular diastolic dysfunction and normal controls by using pulsed Doppler and tissue Doppler methods to calculate the myocardial motility index and to analyze the consistency of the two indexes. To explore the value of Tei index in evaluating left ventricular diastolic function. Methods 140 patients with left ventricular diastolic dysfunction were selected as the case group. According to E / A ratio of pulse Doppler mitral flow spectrum and Ea/Aa ratio of tissue Doppler mitral annular movement velocity, we divided them into moderate left ventricular diastolic dysfunction group (group A) and mild left ventricular diastolic dysfunction group (group B). Group A: 1 E / A 2% EA / A 1 B: 1% E / A 1 A / A 1. 80 healthy subjects matched with age and sex were selected as control group. After routine echocardiography, pulse Doppler Tei index was calculated by pulsed Doppler mitral valve and aortic valve flow spectrum, mitral annular septum was measured by tissue Doppler imaging, and mitral annular septum was measured by tissue Doppler imaging. The peak value of EA Aa velocity in the motion spectrum of two sites on the lateral wall was calculated, the Ea/Aa ratio was calculated, the mean EA Aa of the two sites was replaced by the whole velocity index of the mitral annulus, and the TDI Tei exponents of the two sites were measured, respectively. The average values of two TDI Tei exponents were calculated. 緇撴灉1涓害宸﹀鑸掑紶鍔熻兘鍑忎綆緇

本文編號：1927321