超声心动图评价水面舰艇艇员环球航行后心功能变化

Echocardiographic evaluation of cardiac functions of surface-vessel sailors after global sailing

目的评价水面舰艇艇员环球航海后心功能的变化。方法艇员59名,应用美国GE-vivid5型彩色多普勒超声诊断仪,于胸骨旁取二维左室长轴切面,将M型取样线置于2 a区,测量左室舒张末内径(LVESD)、左室收缩末内径(LVEDS)及心电图R-R间期,计算左室舒张末容量(LVEDV)、收缩末容量(LVESV)、射血分值(LVEF)、左室小轴缩短率(FS)、心排出量(CO)及每搏输出量(SV);于心尖四腔心切面,将脉冲多普勒取样容积置于二尖瓣尖下,分别测量心室舒张早期峰值流速(VE)及舒张晚期峰值流速(VA)、VE/VA比值、等容舒张时间(IVRT)、E峰减速时间(DT)。结果本组人员远航后LVESV、LVEDV、CO、SV值均增加[分别为(40±21)m lvs(38±10)m l,P<0.01;(112±22)m lvs(94±26)m l,P<0.05;(5.2±1.0)Lvs(4.7±1.0)L,P<0.05;(74±16)m lvs(64±14)m l,P<0.01]。主要收缩功能指标LVEF、FS无明显差异,VE值增加[(95±14)cm/svs(85±14)cm/s,P<0.01];DT、IVRT值均降低[(0.16±0.02)svs(0.17±0.03)s,P<0.05及(0.07±0.12)svs(0.11±0.09)s,P<0.05]。A与E/A无明显差异。结论水面舰艇环航后可致心脏舒张功能减低,而主要收缩功能指标则无明显减低。

AIM To evaluate the changes of cardiac functions in surface-vessel sailors after global sail- ing. METHODS The cardiac function indexes in 59 sailors were recorded with the transducer placed in the para-sternum region via left ventricular long-axis view by GE-vivid5 computed sonography, including left ventrieular end diastolic diameter （LVEDD）, left ventricular end systolic diameter （LVESD） and R- R interval. On this plane the M-model sample line was situated at 2a region, and then the left ventricular end diastolic volume （LVEDV）, end systolic volume （LVESV）, ejection fraction （EF）, fraction shortening （FS）, cardiac output （CO） and stroke volume （SV） were detected. On the apical four-chamber view the pulsed Doppler sample volume was situated inferior to mitral valve, and then the ventricular early diastolic peak velocity （VE） and end diastolic peak velocity （VA） were detected respectively. The ratio of VE and VA, isovolumic relaxation time （IVRT） and decelerating time of E peak （DT） were measured. RESULTS LVESV,LVEDV,CO and SV were higher than those before global sailing [ （40 ±21 ） vs （38±10） ml,P〈0.01;（112±22） vs （94±26） ml,P〈0.05;（5.2±1.0） vs （4.7±1.0） L,P〈 0.05;（74 ± 16） vs （64 ± 14） ml,P 〈0.01 ]. VE were higher than those before sailing[ （95± 14） vs （ 85 ± 14） crn/s,P 〈0.01 ] ;DT and IVRT were lower than those before sailing[ （0.16 ±0.02） vs （0.17 ±0.03） s,P〈0.05 and （0.07±0. 12） vs （0.11±0.09） s,P〈0.05]. While EFand FS, the main cardiac function indexes were not different before and after global sailing. CONCLUSION The surfacevessel global sailing may affect the cardiac function of sailors except for systolic function.