【摘要】 目的探究实时三维超声心动图(RT-3DE)评价舒张性心力衰竭(DHF)患者左房容积及功能的变化及其临床应用价值。方法回顾性选取2018年7～12月威海市立医院收治的DHF患者78例作为观察组,以及同一时间内来威海市立医院进行健康体检的健康者78例作为对照组,两组受检者均采用RT-3DE进行检查。比较两组受检者的常规心脏测量指标、左房容积功能指标及左室舒张功能指标。结果观察组受检者心率、左房内径(LAD)和左室收缩功能(LVEF)等各项指标均高于对照组,而左室舒张末期内径(LVEDD)、二尖瓣口舒张期血流速度E、A峰值的比值(E/A)和左室充盈压(E/e)低于对照组差异具有统计学意义(P <0.05);观察组受检者的左房收缩前容积LAVIpreA(28.74±1.56) ml/m~2、左房最大容积LAVImax(32.86±3.55) ml/m~2、左房最小容积LAVImin(20.16±3.68) ml/m~2、主动射血分数LAAEF(34.57±5.33)%、血浆心房利钠肽ANP(588.74±28.76) pg/ml均高于对照组LAVIpreA(16.31±2.13) ml/m~2、LAVI max(20.55±1.08) ml/m~2、LAVImin(8.28±1.14) ml/m~2、LAAEF(19.64±3.81)%、血浆ANP(138.69±37.82) pg/ml差异具有统计学意义(P <0.05);观察组受检者的舒张早晚期血流速度比值(Ea/Aa)、血流传播速度(VP)、峰速比值(S/D)和心脏指数(CI)等指标均低于对照组,而综合指标(E/Ea)和反向血流速度(Ar)高于对照组,差异具有统计学意义(P <0.05)。结论采用RT-3DE能够有效地观察到DHF患者的左房容积及功能的变化情况,在临床上具有较好的应用价值。更多还原

【Abstract】 Objective To explore the changes of left atrial volume and function in patients with diastolic heart failure(DHF) and its clin?ical application value byreal-time three-dimensional echocardiography(RT-3 DE).Methods In this study,78 DHF patients retrospectively admitted to Weihai Municipal Hospital from July to December 2018 were selected as the observation group,and 78 healthy people who came to Weihai Municipal Hospital for health examination at the same time were selected as the control group.Both groups of patients were examined by RT-3 DE.The routine cardiac measurements,left atrial volume function and left ventricular diastolic function were analyzed.Results The heart rate,left atrial diameter(LAD) and left ventricular systolic function(LVEF) of the subjects in the observation group were higher than those in the control group,while the ratio of left ventricular end diastolic diameter(LVEDD),diastolic velocity e,peak a(E/A) and left ventricular filling pressure(E/e’) were lower than those in the control group,with significant difi-erence(P<0.05).The LAVI preA(28.74±1.56) ml/m~2,LAVI Max(32.86±3.55) ml/m~2,LAVI min(20.16±3.68) ml/m~2,LAAEF(34.57±5.33) % and ANP(588.74±28.76) pg/ml of the left atrium in the observation group were higher than those in the control group in pre-systolic LAVI A(16.31±2.13) ml/m~2,LAVI Max(20.55±1.08) ml/m~2 and LAVI min.(8.28±1.14) ml/m~2,active ejection fraction LAAEF(19.64±3.81)%,plasma atrial natriuretic peptide ANP(138.69±37.82) pg/ml,the difference was statistically significant(P <0.05).The early and late diastolic blood flow velocity ratio(Ea/Aa),blood flow propagation velocity(VP),peak velocity ratio(S/D) and cardiac index(Cl) in the observation group were lower than those in the control group,while the comprehensive index(E/Ea) and reverse blood flow velocity(Ar) were higher than those in the control group,with significant difference(P <0.05).Conclusion RT-3 DE can be performed to observe effectively the changes of left atrial volume and function in patients with DHF,and has a good clinical application value.更多还原