本文選題：實(shí)時(shí)三維超聲心動(dòng)圖 + 左心室室壁瘤�。� 參考：《蘭州大學(xué)》2017年碩士論文

【摘要】：目的:應(yīng)用實(shí)時(shí)三維超聲心動(dòng)圖(real-time three-dimensional echocardiography,RT-3DE)對(duì)行急診PCI的左心室室壁瘤(left ventricular aneurysm,LVA)患者的術(shù)前及術(shù)后2個(gè)月心功能的相關(guān)指標(biāo)進(jìn)行對(duì)比,評(píng)估急診PCI的短期療效。方法:應(yīng)用RT-3DE收集31例急性前壁心肌梗死(acute myocardial infarction,AMI)并LVA患者術(shù)前、術(shù)后2月左心室的心功能參數(shù),主要包括:左心室舒張末期容積(left ventricular end-diastolic volume,LVEDV)、收縮末期容積(End-systolic volume,ESV)、心排血量(cardiac output,CO)、左心室射血分?jǐn)?shù)(left ventricular ejection fraction,LVEF)及球形指數(shù)(spherical index,SPI),根據(jù)體表面積(body surface area,BSA(m2)=0.0061x身高(cm)+體重(kg)),計(jì)算出左室舒張末期容積指數(shù)(LVEDVI)、收縮末期容積指數(shù)(ESVI)、心臟指數(shù)(Cardiac index,CI)(LVEDVI=LVEDV/BSA,ESVI=ESV/BSA,CI=CO/BSA)。將研究對(duì)象分成功能性LVA(12例),解剖性LVA(11例),伴有血栓性LVA(8例)。對(duì)其術(shù)前、術(shù)后2月的心功能參數(shù)進(jìn)行組內(nèi)及組間比較;并對(duì)術(shù)前、術(shù)后2月的SPI、LVEF與相關(guān)心功能指標(biāo)進(jìn)行相關(guān)性分析。結(jié)果:(1)功能組術(shù)后2月的LVEF比術(shù)前增高,SPI降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)解剖組術(shù)前、術(shù)后2月的CO、CI、LVEF、SPI差異有統(tǒng)計(jì)學(xué)意義(P0.05),CO、CI、LVEF術(shù)后2月比術(shù)前高,SPI術(shù)后減低,其中SPI、LVEF顯著性更高一些(P0.01)。(3)血栓組術(shù)后2月的SPI比術(shù)前有所下降,差異有統(tǒng)計(jì)學(xué)意義(P0.05);LVEF術(shù)后2月比術(shù)前有所提高(P0.05),差異無統(tǒng)計(jì)學(xué)意義。(4)三組組內(nèi)相比:術(shù)后2月的LVEDV、ESV、EDVI、ESVI均比術(shù)前有所降低,但差異無統(tǒng)計(jì)學(xué)意義(P0.05)。(5)三組組間比較:術(shù)前及術(shù)后2月LVEF及SPI差異無統(tǒng)計(jì)學(xué)意義(P0.05)(6)(1)術(shù)前及術(shù)后2月的SPI與LVEF值呈負(fù)相關(guān),與LVEDV、ESV、EDVI、ESVI、CO、CI呈正相關(guān)。(2)術(shù)前及術(shù)后2月的LVEF值與SPI、LVEDV、ESV、EDVI、ESVI、CO、CI呈負(fù)相關(guān),其中LVEDV、ESV、EDVI、ESVI(P0.01)、CO、CI(P0.05)與LVEF值相關(guān)性有統(tǒng)計(jì)學(xué)意義。結(jié)論:(1)功能性和解剖性LVA患者PCI術(shù)后2月左心室形態(tài)及整體收縮功能改善,手術(shù)有效果;伴有血栓性LVA術(shù)后2月療效不明顯。(2)3RT-DE是評(píng)價(jià)急診PCI對(duì)LVA患者的短期療效的一種有效的方法,其中SPI及LVEF是重要的兩個(gè)指標(biāo)。
[Abstract]:Objective: to evaluate the short-term efficacy of three-dimensional in patients with left ventricular aneurysm (LVA) before and 2 months after emergency PCI by real-time three-dimensional echocardiography (RT3DE). Methods: the cardiac function parameters of left ventricle were collected from 31 patients with acute anterior wall myocardial infarction (AMI) and acute myocardial infarction (LVA) 2 months after operation by RT-3DE. These include left ventricular end-diastolic volume, end systolic volume, cardiac output, left ventricular ejection fraction and spherical index. According to body surface area, surface areaBSAm2X 0.0061x body height and body weight, the left ventricular ejection fraction (LVEF) and spherical index (SPII) are calculated according to the body surface area (surface areaan BSAm2P 0.0061x height / cm) and the left ventricular ejection fraction (LVEF) and the spherical index (SPII). The left ventricular ejection volume is calculated according to the body surface area (surface areaBSAm2X 0.0061x height / cm ~ (-1) and the left ventricular ejection fraction (LVEF) is calculated according to the body surface area (body surface area). End diastolic volume index (LVEDVI), end systolic volume index (ESVI), cardiac index (cardiac index), LVEDVI / BSAV / ESV/ BSAI / ESVP / BSAI / BSAA. The subjects were divided into 12 cases of functional LVAV, 11 cases of anatomic LVAV and 8 cases of thrombotic LVAV. The parameters of cardiac function before and after 2 months of operation were compared within and between groups, and the correlation between SPI LVEF and related cardiac function indexes was analyzed before and 2 months after operation. Results two months after operation, LVEF in functional group was significantly lower than that before operation. The difference was statistically significant (P 0.05). SPI of two months after operation was significantly lower in the dissection group than that in the control group (P < 0.05). The SPI of the two months after operation was significantly lower than that of the high SPI in the two months after operation, and the difference of SPI between two months after operation and two months after operation was significantly lower in the functional group than that in the preoperative high SPI. The SPIIV LVEF was significantly higher in the thrombus group than that in the preoperative group, and the SPI in the thrombus group was significantly lower at 2 months after operation than that in the preoperative group. There was a significant difference in LVEF between two months after operation and two months after operation. The difference was not statistically significant. There was no significant difference among the three groups: the EDVIESVI of LVEDVV ESVV / EDVIESVI was lower than that of preoperation 2 months after operation. But there was no significant difference among the three groups: there was no significant difference in LVEF and SPI between the three groups before and 2 months after operation. (P < 0.05) SPI was negatively correlated with LVEF before and 2 months after operation, but positively correlated with ESVICOCI before and after operation, and was negatively correlated with ESVI / ESVICOCI before and 2 months after operation, and there was a negative correlation between LVEF before and 2 months after operation and SPIVEDVE ESVI / ESVICOCI (P < 0. 05) before and 2 months after operation, there was a negative correlation between SPI and LVEF before and 2 months after operation, but there was a positive correlation between SPI and LVEF before and 2 months after operation. Among them, LVEDVV ESVI (ESVI) (P0.01) and LVEF (P0.05) were significantly correlated with LVEF. Conclusion the left ventricular morphology and global systolic function were improved 2 months after PCI in patients with functional and anatomical LVA. 2 months after operation with thrombotic LVA, 3RT-DE is an effective method to evaluate the short-term efficacy of emergency PCI in LVA patients. SPI and LVEF are two important indexes.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R541;R540.45

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