实时三维超声心动图在评价限制型心肌病中的应用价值

The application value of real-time three-dimensional echocardiography in patients with restrictive cardiomyopathy

目的探讨实时三维超声心动图时间-位移参数及17节段时间-容积曲线参数指标在评价限制型心肌病中的应用价值。方法对8例限制型心肌病患者（经活检证实）、28例正常者（对照组）行实时三维超声心动图检查。结果限制型心肌病组的17节段时间一容积曲线参数指标包括左室16节段、12节段、6节段达到最小收缩容积时间的标准差（Tmsv16SD，Tmsv12-SD，TmSV6SD），左室16节段、12节段、6节段达到最小收缩容积时间的最大差值（Tmsv16-Dif，Tmsv12Dif，Tmsv6-Dif）以及达到最小收缩容积时间的标准差的百分数（Tmsv16-SD％，Tmsv12-SD％，Tmsv6-SD％），达到最小收缩容积时间的最大差值的百分数（Tmsv16-Dif％，Tmsv12-Dif％，Tmsv6-Dif％）较正常组显著增高，差异有统计学意义（P均〈0．005），限制型心肌病的时间-位移参数中位移平均值、最大值及最小值明显低于正常对照组，差异有统计学意义（P〈0．001，P〈0．001，P〈0．005），且17节段时间-容积曲线指标诊断限制型心肌病的敏感性、特异性、阳性预测值、阴性预测值较高，差异有统计学意义（P〈0．05）。结论实时三维超声心动图时间位移参数及17节段时间-容积曲线参数能快速准确地评价限制型心肌病患者心肌节段功能及收缩同步性。

Objective To investigate the value of real time three-dimensional echocardiography timing-excursion parametric index and 17 segment volume curves index in patients with restrictive cardiomyopathy. Methods Eight patients with restrictive cardiomyopathy （proven by biopsy） ,twenty eight subjects with normal left ventricular（LV） function were examined by Philips iE33 with X3-1 probe. Results Parameter index of the SD and maximum difference of Tmsv of 16 segments, 12 segments, and 6 basal segments（Tmax 16SD, Tmsv-12SD Tmsv -6SD, Tmsv-16Dif, Tmsv-12 Dif, Tmsv-6Dif, Tmsv 16 SD%, Tmsv 12-SD% ,Tmsv 6-SD%, Tmsv 16-Dif%, Tmsv 12 Dif%, Tmsv 6-Dif%） was significantly higher in patients with restrictive cardiomyopathy than that in subjects with normal LV function （all P 〈 0.001 ）. Average and maximum value and minimum of excursion was significantly lower in patients with restrictive cardiomyopathy than that in subjects with normal LV function（ P 〈0. 001, P 〈0. 005, P〈0. 005）. And parameter index of 17 segment volume curves index showed higher sensitivity, specificity, positive predictive value and negative predictive value for diagnose restrictive cardiomyopathy. Conclusions Real-time three-dimensional echocardiography can evaluate and diagnose restrictive cardiomyopathy lastly.