定量实时三维超声心动图在评价限制型心肌病及缩窄性心包炎中的应用价值

Value of real-time three-dimensional echocardiography in patients with restrictive cardiomyopathy and constrictive pericardits

目的探讨实时三维超声心动图时间一位移参数及17节段时间-容积曲线参数指标在评价限制型心肌病及缩窄性心包炎中的应用价值。方法对17例限制型心肌病患者（经活检证实）、6例缩窄性心包炎（经CT或手术证实）、20例正常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-容积曲线参数指标：16节段达到最小收缩容积的时间标准差以及标准差的校正值（Tmsv16-SD，Tmsv16-SD％）、12节段达到最小收缩容积的时间标准差以及标准差的校正值（Tmsv12-SD，Tmsv12-SD％）、6节段达到最小收缩容积的时间标准差以及标准差的校正值（Tmsv6-SD，Tmsv6-SD％）、16节段达到最小收缩容积的时间最大差值以及最大差值的校正值（Tmsv16Dif，Tmsv16-Dif％）、12节段达到最小收缩容积的时间的最大差值及最大差值的校正值（Tmsv12-Dif，Tmsv12-Dif％）、6节段达到最小收缩容积的时间的最大差值及最大差值的校正值（Tmsv6-Dif，Tmsv6-Dif％）较正常组显著增高，差异有统计学意义（P均〈0．05），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均〈0．005），而缩窄性心包炎组的17节段时间-容积曲线参数指标及时间-位移参数指标与正常对照组比较差异无统计学意义（P均〉0．05）。结论实时三维超声心动图时间-位移参数显像及17节段时间-容积曲线参数指标能快速、准确地评价限制型心肌病患者及缩窄性心包炎患者心肌节段收缩功能及收缩同步性。

Objective To investigate value of real-time three-dimensional echocardiography timingexcursion parametric index and 17 segment volume curves index in patients with restrictive cardiomyopathy and constrictive pericardits. Methods Seventeen patients with restrictive cardiomyopathy （proven by biopsy） ,six patients with constrictive pericardits （proven by CT or surgical）, twenty subjects with normal left ventricular（LV） function were examined by Philips iE33 with X3 1 probe. Results Parameter index of Tmsv 16-SD,Tmsv 12-SD Tmsv 6 SD,Tmsv 16-Dif,Tmsv 12-Dif,Tmsv 6-Dif,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 d0.05）. Average and maximum value and minimum of excursion was significantly lower in patients with restrictive cardiomyopathy than that in subjects with normal LV function （all P〈0. 005）. Whereas, compare with subjects with normal LV function, the parametric indexes of timing-excursion and 17 segment volume curves were not significantly difference in patients with constrictive pericardits（all P〉0. 05）. Conelusions Real-time three-dimensional echocardiography can evaluate and diagnose fastly restrictive cardiomyopathy and constrictive pericardits.