多普勒超声心肌运动指数评价卡维地洛对心力衰竭左心功能的影响

Evalution of the effect of carvedilol on left ventricular function by Doppler ultrasound MPI in patients with heart failure

目的通过多普勒超声测定左心室心肌运动指数评价心力衰竭患者应用卡维地洛治疗前后心功能的变化。方法收集哈尔滨医科大学第一临床医学院2004—2006年住院和门诊的患者,其中正常对照组50名,慢性心力衰竭组45例,观察治疗前和治疗后1个月、6个月时分别用多普勒超声测量左心室传统Tei指数(c-Tei)和组织多普勒Tei指数(t-Tei)、左室射血分数(LVEF)等指标。结果慢性心力衰竭组较正常对照组左心室舒张末期内径(LVEDd)、c-Tei和t-Tei明显增高(P<0.05),LVEF明显降低(P<0.05);卡维地洛治疗1个月时,c-Tei和t-Tei明显改善(P<0.05);治疗6个月时,c-Tei、t-Tei、LVEF、LVEDd和美国纽约心脏协会心功能分级较治疗前均明显改善(P<0.05)。结论应用Tei指数对心力衰竭患者心功能进行评价简便、可行,c-Tei和t-Tei具有同等作用。

Objective To evaluate the effects of carvedilol on left ventricular function by MPI in patients with heart failure. Methods All the cases came from the first Affiliated Hospital of Harbin Medical University during 2004 to 2006. There were two groups：45 Carvedilol treated patients and 50 placebo controlled patients. The patients with heart failure were detected the conventional Tei index（c-Tei） ,the tissue Doppler Tei index（ t-Tel ）and left ventricular ejection fraction pretherapy and post-treatment 1 month and 6 month. Results The patients with heart failure were higher in LVEDd, c-Tei, t-Tei and lower in LVEF compared with the controlled patients （ P 〈 0. 05 ） ;after the treatment of carvedilol was performed 1 month, c-Tei and t-Tei （ P 〈 0. 05 ） were greatly improved （ P 〈 0. 05 ） ; then after the treatment of 6 months, c-Tei ,t-Tei, LVEF ,LVEDd and NYHA were improved significantly （P 〈 0.05 ）. Conclusion It＇s a good way to use the Tei index to evaluate the patient＇s failing heart. The c-Tei is as good as the t-Tei. The Tel index could be used to evaluate the failing heart after the treatment of carvedilol earlier.