摘要
目的 应用三维斑点追踪成像技术初步评价慢性心力衰竭（CHF）患者左心室整体径向、纵向、环向收缩期峰值应变特征,并探讨其价值及可行性.方法 CHF患者29例（CHF组）及正常志愿者34例（正常组）,采集标准心尖四腔切面左心室全容积图像并存储,应用3-D trace软件进行在线分析,自动计算左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）、左心室射血分数（LVEF）、左心室整体纵向收缩期峰值应变（LVGLS）、左心室整体环向收缩期峰值应变（LVGCS）及左心室整体径向收缩期峰值（LVGRS）,并比较CHF组与正常组之间的各应变指标变化情况及与LVEF的相关性.结果 CHF患者左心室LVEF、LVGLS、LVGCS、LVGRS较正常组减低（P＜0.05）.LVGLS、LVGCS、LVGRS与LVEF相关系数分别为0.846、0.871和0.828（P＜0.01）.结论 CHF患者左心室整体功能明显减低,三维斑点追踪技术可无创、客观地评价左心室整体收缩功能,为评价左心室功能提供一个新的手段.
Objective To evaluate pulmonary hypertension of total anomalous pulmonary venous connection （TAPVC） by eehocardiography by comparing the results before operation, 7 days after post-operation and 3 months after operation and to conclude methods for evaluation of pulmonary hypertension （PH）. Methods A total of 65 TAPVC patients were included in the study. The echo were performed before operation, 7 days and 3 months after operation. The cardiac structure and function were supervised with 2D echo and tricuspid valve regurgitation maximum pressure gradient （PTR） were measured with continuous Doppler. The pulmonary venous trunk was diagnosed as obstruction （PVO） in case the blood flow velocity came to 1.5 m/s or more measured with pulse Doppler. The method to evaluate and measure pulmonary hypertension second to TAPVC were assessed. Results Almost all the TAPVC patients were diagnosed as pulmonary hyper-tension with PTR （65.30±23.33） mm Hg, and 13 patients were diagnosed as PVO. The sixty-two patients were performed operations. The PTR decreased distinctively [ （33.82±13.68 ） mm Hg, P = 0. 000 ] in 60 patients 7 days after operation. The one patient with supra-cardiac TAPVC without decreased PTR as expected were found as obstruction in the anastomosis between the pulmonary venous trunk and the left atrium. Another patient with supra-cardiac TAPVC were found with serious PH and mild stegnosis on the anastomosis 3 months later. Finally, the patients were deduced as stegnosis on the branches of pulmonary venous. In 3 months after operation, the PTR reduced to normal value in 47 patients and the tricuspid valve regurgitation disappeared in 11 patients. The obstruction in anostomosis were diagnosed in 2 patients with a high PTR. Conclusion Most of pulmonary hypertension following TAPVC could become normal after operations.The continuously high PTR were led by obstruction in anastomosis. Pulmonary hypertension can be assessed accurately as well as the existence of PVO by echo.
出处
《中华医学超声杂志（电子版）》
2010年第8期29-32,共4页
Chinese Journal of Medical Ultrasound(Electronic Edition)
关键词
超声心动描记术
完全型肺静脉异位引流
肺动脉高压
Ultrasonography
Total anomalous pulmonary venous connection
Pulmonary hypertension
