LEJ-1全方向M型超声心动图系统对左室局部与整体收缩功能量变关系的研究

Relationship of Quantitative Changes between Regional and Integral Systolic Function of Left Ventricle on M-mode Echocardiography

目的 采用全方向M型超声心动图测定左室局部室壁的收缩功能指标 ,观察局部室壁的收缩功能与整体收缩功能的量变关系。方法 研究对象为正常组及不同心功能状态的心梗组。采用福州大学无线电系研制的LEJ 1全方向M型心动图系统 ,对胸骨旁左心室短轴二尖瓣水平、乳头肌水平、心尖水平的二维图像进行采集和定标 ,用手动分析法对左心室前、侧、后、下、前间隔和后间隔 16个室壁节段的运动曲线测量收缩幅度 (R) ,收缩末厚度 (Ts) ,舒张末厚度 (Td) ,每个测值取连续三次测量的平均值 ,并计算室壁增厚率 (ΔT % )。结果 心梗各组受累节段的局部收缩幅度R和室壁增厚率ΔT %的平均测值均较正常组小 ;而且各组所有节段R和ΔT %的平均测值与整体收缩功能指标具有良好的相关性 ;以ΔT %的结果来看Ⅰ组受累面积平均约 10 .63 % ( 1.7段 ) ,Ⅱ组约 14 .3 8% ( 2 .3段 ) ,Ⅲ组约 2 6.2 5 % ( 4 .2段 ) ,Ⅳ组约5 3 .75 % ( 8.6段 ) ,说明随着局部收缩功能受累范围的扩大 ,整体收缩功能下降 ;当明显受累室壁节段达 2个 (面积约12 .5 % )以上时 ,整体收缩功能指标EF才会低于正常。结论 左室局部收缩功能受累范围和程度与左室整体收缩功能减退程度存在明显正比例量变关系。

Objective To assess the relationship of quantitative changes between regional systolic function and integral systolic function of left ventricle by applying omni-directional M-mode echocardiography.Methods The study groups included four myocardial infarct (MI) subgroups (groupⅠ:EF≥55%; groupⅡ:50%≤EF<55%; groupⅢ:40%≤EF<50%; groupⅣ:EF<40%) and control group.Their short-axis sections at mitral valve level,papillary muscle level and apical level were recorded and analyzed by LEJ-1 omni-directional M-mode echocardiography system.The left ventricle was subdivided into 16 segments.Wall range during systolic period (R),end-systolic thickness (Ts),end-diastolic thickness (Td) of rengional walls were measured,and the percentage of wall thickening (ΔT%) of each wall was calculated.Results The average value of R and ΔT% of regional walls in each MI subgroup were smaller than those of control group; there were correlations between those values and the integral systolic functional indexes; in according to the values of ΔT%,the area of involved region of each MI subgroup increased (Ⅰ group:10.63%,1.7 segments;Ⅱ group:14.38%,2.3 segments;Ⅲ group:26.25%,4.2 segments;Ⅳgroup:53.75%,8.6 segments).Conclusion Measuring R and ΔT% of regional left ventricular wall on subjects at different states by using omni-directional M-mode echocardiography could detect that the area and degree of regional systolic dystunction were in a positive proportion to the integral systolic function.