【摘要】：目的:應用二維斑點追蹤成像(2D-STE)技術(shù)及實時三維超聲心動圖(RT-3DE)評價無癥狀飲酒者隨著飲酒時間因素的改變對左心房功能的影響。方法:選取30例在我院體檢健康的不飲酒男性作為A組(對照組)。選取92例無臨床癥狀的男性飲酒者,飲酒時間大于5年,日飲酒量白酒90~120g(即純乙醇75~100ml)或啤酒2~3瓶(1000~1500ml)。根據(jù)飲酒時間的長短將其分為三組:B組:30名,飲酒時間5~9年(平均為7±2年);C組:31名,飲酒時間10~15年(平均為12±1年);D組:31名,飲酒時間大于15年(平均為18±2年)。均排除冠心病、高血壓、糖尿病、心肌病、心律失常、心臟瓣膜病等心血管疾病及肝損害、腎損害等其他高危因素。1、對A、B、C、D四組行常規(guī)超聲檢查。常規(guī)測量參數(shù)包括:左室舒張末期內(nèi)徑(LVDd)、左室收縮末期內(nèi)徑(LVDs)、舒張末期室間隔厚度(IVSTd)、舒張末期左室后壁厚度(PWd)、左室射血分數(shù)(LVEF)以及短軸縮短率(FS);應用左心房(LA)容積曲線測量左心房最大容積(LAVmax)、最小容積(LAVmin)及左心房收縮前容積(LAVp),通過計算得到左心房被動射血分數(shù)(LAPEF)及左心房主動射血分數(shù)(LAAEF)。2、對A、B、C、D四組行2D-STE檢查。2D-STE測量指標包括:心室收縮期左心房整體應變率(SRs),心室舒張早期左心房整體應變率(SRe),心室舒張晚期左心房整體應變率(SRa)。3、對A、B、C、D四組行RT-3DE檢查。RT-3DE測量參數(shù)包括左心房最大容積(LAVmax)、最小容積(LAVmin)、左心房主動收縮前容積(LAVp)、左心房被動射血分數(shù)(LAPEF)、左心房主動射血分數(shù)(LAAEF)。結(jié)果:1、常規(guī)超聲檢查結(jié)果:B組所有指標與A組比較無統(tǒng)計學意義(均P0.05)。C組LAVmin、LAVmax、LAVp及LAAEF與A、B組比較明顯增大(均P0.05),LAPEF明顯減少(均P0.05)。D組LVDd、LVDs、IVSTd、PWd、LAVmin、LAVmax及LAVp與A、B、C組比較明顯增大(均P0.05),LVEF、FS、LAPEF及LAAEF明顯減少(均P0.05)。2、2D-STE檢查結(jié)果:B組所有指標與A組比較無統(tǒng)計學意義(均P0.05)。C組SRa與A、B組比較明顯增大(均P0.05),SRs及SRe明顯減少(均P0.05)。D組與A、B、C組比較SRs、SRe及SRa明顯減少(均P0.05)。3、RT-3DE檢查結(jié)果:B組所有指標與A組比較無統(tǒng)計學意義(均P0.05)。C組LAVmin、LAVmax、LAVp、LAAEF與A、B組比較明顯增大(均P0.05),LAPEF明顯減少(均P0.05)。D組LAVmin、LAVmax及LAVp與A、B、C組比較明顯增大(均P0.05),LAPEF、LAAEF明顯減少(均P0.05)。結(jié)論:1、左房功能的損害會根據(jù)飲酒時間的改變而改變,2D-STE技術(shù)能夠有效評價無癥狀飲酒者隨著飲酒時間因素改變左心房功能的變化情況。2、RT-3DE可以有效評估左心房儲存、通道、助力泵三大功能,能夠反映無癥狀飲酒者隨著飲酒時間因素改變左心房功能的變化情況,可被視為評估左心房容量和作用的精準、高效和可靠的衡量依據(jù)。
[Abstract]:Objective: To evaluate the effect of asymptomatic drinkers on left atrial function with the change of drinking time by two-dimensional speckle tracking imaging (2D-STE) and real-time three-dimensional echocardiography (RT-3DE). They were divided into three groups according to the drinking time: group B: 30, drinking for 5 to 9 years (average 7 2 years); group C: 31, drinking for 10 to 15 years (average 12 1 year); group D: 31, drinking for more than 15 years (average 18 2 years). Cardiovascular diseases such as coronary heart disease, hypertension, diabetes, cardiomyopathy, arrhythmia, heart valve disease, liver damage, kidney damage and other high-risk factors were excluded. Left atrial passive ejection fraction (LAPEF) and left atrial active ejection fraction (LAAEF) were calculated by measuring left atrial maximum volume (LAVmax), minimum volume (LAVmin) and left atrial pre-systolic volume (LAVp). 2. Four groups A, B, C, D were examined by 2D-STE. The two-dimensional-STE measurements included: left atrial global strain rate (SRs), early diastolic global strain rate (SRe), late diastolic global strain rate (SRa). Results: 1. Routine ultrasonography showed that there was no significant difference in all indexes between group B and group A (all P 0.05). In group C, LAVmin, LAVmax, LAVp and LAAEF were significantly increased (all P 0.05), and LAPEF was significantly decreased (all P 0.05). LVDd, LVDs, IVSTd, PWd, LAVmin, LAVmax, LAVp and A, B, C group were significantly increased (all P 0.05), LVEF, FS, LAPEF and LAAEF were significantly decreased (all P 0.05). 2, 2-D-STE results: All indicators in group B were not statistically significant compared with group A (all P 0.05). SRa and A in group C were significantly increased (all P 0.05), SRs and SRe were significantly decreased (all P 0.05). Compared with group A, B, C, SRs, SRe and SRa decreased significantly (all P 0.05). 3, RT-3DE results: All the indicators of group B and group A were not statistically significant (all P 0.05). Group C LAVmin, LAVmax, LAVp, LAAEF and group A, B were significantly increased (all P 0.05), LAPEF decreased significantly (all P 0.05). Group D LAVmin, LAVmax and LAVp were significantly increased compared with group A, B, C (all P 0.05). Conclusion: 1. The impairment of left atrial function can be changed according to the change of drinking time. 2. RT-3DE can effectively evaluate the changes of left atrial function in asymptomatic drinkers with the change of drinking time. Alcoholics'changes in left atrial function as a result of time consuming can be regarded as an accurate, efficient and reliable measure of left atrial volume and function.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R540.45

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