应用多普勒超声检测年轻吸烟者吸烟后左心舒张功能急性效应的研究

Acute effects of left ventricular function by doppler echocardiography in young smokers after smoking

目的研究吸烟对年轻人左心舒张功能的急性影响。方法选择参加体检的年轻男性吸烟者42人,于5min内吸完1支香烟,通过量血压,应用二维超声、脉冲多普勒和多普勒组织成像技术对吸烟前与吸烟后的各项左室收缩、舒张功能指标进行检测并对比分析。结果吸烟后舒张功能参数在吸烟后发现有明显变化,其中二尖瓣口舒张晚期充盈峰速度(A峰)、舒张早期E峰的减速时间(EDT)、等容舒张时间(IVRT)、二尖瓣环舒张晚期运动速度(Am峰)、肺静脉口收缩期S波、S/D比值分别较吸烟前明显增大,二尖瓣口舒张早期充盈峰速度(E峰)、E/A值、二尖瓣环舒张早期运动速度(Em峰)、Em/Am值、肺静脉舒张早中期D波分别较吸烟前明显降低,差异均有统计学意义(t分别=-4.81、-7.02、-4.76、-3.77、-6.91、-7.20;5.43、8.02、4.07、7.03、3.98,P均<0.05)。所有收缩功能指标包括DBP、舒张末容量(LVEDV、LVESV)、每搏量(SV)、心输出量(CO),心脏指数(CI)均无明显变化,差异均无统计学意义(t分别=0.98、-0.26、-0.04、-0.20、-1.68、-1.60,P均>0.05)。结论年轻吸烟者吸烟后左室舒张充盈(松驰功能)明显减低,二尖瓣环组织运动速度是反应左室舒张功能较好的指标。

Objective Toassess the acute effects of left ventricular （LV） function in young smokers after smoking. Methods The participants were 42 young male volunteers.The systolic and diastolic function indexes of LV were measured with doppler echocardiography before and after smoking one cigarette immediately and evaluated. Results All systolic indexes of LV did not significantly change after smoking. The parameters of diastolic function were changed after smoking immediately.The A,EDT,IVRT,Am,S and S/D increased significantly after smoking;the E,E/ A,Em,Em/Am and D decreased significantly after smoking. There were significant differences compared with those before smoking （t=-4.81,-7.02,-4.76,-3.77,-6.91,-7.20;5.43,8.02,4.07,7.03,3.98,P〈0.05）. Conclusions Left ventricle diastolic filling （relax function） shows apparent impairment immediately after smoking. The TDI of mitral valve annular is a good factor to reflect left ventricle diastolic function.