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实时三维超声心动图评价肥厚型心肌病左室同步性的研究

Left Ventricular Synchronicity in Hypertrophic Cardiomyopathy:Real Time Three-dimensional Echocardiography

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目的:应用实时三维超声心动图(real time three-dimensional echocardiography, RT-3DE)评价肥厚型心肌病(hypertrophic cardiomyopathy, HCM)患者左室心肌同步性。方法:所有研究对象均为大连大学附属中山医院2012年10月-2013年5月门诊或住院患者。对照组:选择经问诊、查体、心电图、胸部X线及心脏超声等检查,确定心肺无异常、无内分泌疾病、肝肾疾病及免疫系统疾病的健康成人30人,其中男14人,女16人,年龄37-79(56.61±10.56)岁。肥厚型心肌病组:选择室间隔中上部肥厚型心肌病患者31人,其中男17人,女14人,年龄37-87(60.93±14.48)岁。无左室流出道梗阻,无明显临床症状,尚未接受临床干预性治疗,并排除其它心脏疾患(高血压、冠心病、先天性心脏病、风湿性心脏病、心律失常等)、影响心功能的内分泌疾病(糖尿病、甲亢等)以及肝、肾疾病和免疫系统疾病。采用PHILIPS iE33彩色多普勒超声诊断仪,连接心电图,X3-1探头于心尖四腔切面采集实时三维超声图像,测量各组左室整体射血分数(left ventricular ejection fraction, LVEF)、各节段达容积最小时间的标准差(Tmsv16 SD)及该标准差与心电图R-R间期的比值(Tmsv16 SD*)。比较两组间各参数差异。结果:1.左室整体射血分数HCM组与正常对照组比较无统计学意义(P>0.05)。2.与正常对照组比较,HCM组的Tmsv16 SD、Tmsv16 SD*增加,具有统计学意义(P<0.05)。结论:肥厚型心肌病患者在尚无明显临床症状、左室整体收缩功能正常的情况下,左室整体同步性已减低。
Objective: To evaluate left ventricular synchronicity with hypertrophic cardiomyopathy by real-time three-dimensional echocardiography. Methods: There were 31 HCM patients (upper interventricular septum hypertrophy without left ventricular outflow obstruction) with normal liver and kidneys without endocrine disease, immune system disease and other heart diseases like hypertension, coronary artery disease, congenital heart disease, rheumatic heart disease and arrhythmia. Al the HCM patients were asymptomatic and hadn’t received any clinical treatment yet. 30 normal persons were selected after interrogation enquiry, physical examination, ECG, chest X-ray and echocardiography. Al the patients were checked between October 2012 and May 2013 in affiliated zhongshan hospital of Dalian university. Left ventricular ejection fraction (LVEF), Tmsv16 SD, and Tmsv16 SD* were detected by X3-1 probe, 4 chamber apex view using real-time three-dimensional echocardiography.Results: 1. There was no difference between HCM team and normal team in LVEF(P>0.05).2. Tmsv16 SD、Tmsv16 SD* increased in HCM team and there was significant difference between the two teams(P<0.05).Conclusion: Left ventricular synchronicity decreased in HCM patients without symptoms when LVEF is normal.

real-time three-dimensional echocardiographyhypertrophiccardiomyopathyleft ventricular synchronicity

尹丽、郭丽苹、薛炜

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大连大学附属中山医院超声科 116001

实时三维超声心动图 心肌病 肥厚型 左室同步性

2014

中外健康文摘
中国中医药报社

中外健康文摘

影响因子:0.016
ISSN:1672-5085
年,卷(期):2014.(12)
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