摘要
目的采用组织多普勒成像(dopplertissueimaging,DTI)以及基于此技术的定量组织速度成像(quantitativetissuevelocityimaging,QTVI),定量测量风湿性心脏病患者换瓣手术前后心脏各部分各时相运动速度、幅度,分析心肌舒缩功能的变化,以指导临床。方法25例风湿性心脏病患者术前、术后1、3个月的心脏运动情况与20例正常成年人进行测量及分析比较。结果①患者较正常对照组心脏各腔室均有增大,尤其是心房(P<0.01);左右心室射血分数(EF)及左室短轴缩短百分率(FS)则明显较正常降低(P<0.01);术后1个月左室EF进一步降低(P<0.05);术后3个月左房、左室有所减小(P<0.05);②患者较正常对照组心脏二尖瓣环、三尖瓣环下移距离显著减小(P<0.01),二尖瓣E波最大流速显著增大(P<0.01);术后1个月三尖瓣环下移距离继续减小(P<0.01),二尖瓣E波最大流速降低(P<0.01);术后3个月三尖瓣环下移距离有所增大(P<0.05);患者术前室间隔、左室外侧壁、右室外侧壁大部分有关舒张、收缩指标均低于正常(P<0.01),术后1月这部分指标较术前降低,术后3个月室间隔舒张、左室收缩有关指标继续降低,而右室大部分舒张、收缩有关指标有所升高(P<0.05)。结论术后3个月右心功能开始恢复,而左心功能仍维持低水平,需要继续药物治疗,且有必要做更长时间的随访,以便指导对患者术后的治疗。
Objective To evaluate the heart function in patients with rheumatic heart disease before and after valve replacement operation by quantitative tissue velocity imaging （QTVI）. Methods Twenty-five patients with rheumatic heart disease and the matched 20 healthy individuals were enrolled. The parameters of heart movement were measured by QTVI. The patients were measured at preoperative period, postoperative 1st month and 3rd month respectively. Results ① Both the atriums and ventricles in patients were larger than ones in control group （ P 〈0. 01 ）. LVEF, RVEF, FS were lower than control group （ P 〈0.01 ）. And LVEF continued to reduce 1 month after operation （P 〈0.05 ）. Left ventricles and left atriums became smaller in 3rd month after operation （P 〈 0. 05）. ②The SD of mitral and tricuspid annuli was more lower than control group （ P 〈0. 01 ）, and E velocity of mitral flow was higher （ P 〈0. 01 ）. The SD of tricuspid annular continued to reduce and E velocity of mitral flow decreased 1 month after operation （P 〈 0.01 ）. The SD of tricuspid annuli began to increase in 3rd month after operation （P 〈 0.05 ）. The most parameters relative to septum, outside wall of left and right ventricles in patients were lower than ones in control group （P 〈 0. 01 ）. And they decreased after postoperative 3 months （ P 〈 0. 05 ） , the parameters related to diastole in septum and to systole in left ventricle continued to decrease but parameters in right ventricle began to increase （ P 〈 0. 05 ）. Conclusion In those patients feeling better shortly after operation, drug therapy is still needed, because the injured myocardium has not recovered completely.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2005年第24期2460-2463,共4页
Journal of Third Military Medical University
关键词
风湿性心脏病
瓣膜置换术
心功能
超声心动图
组织多普勒
chronic rheumatic heart disease
heart valve replacement
heart function
echocardiography
Doppler tissue imaging
