肺心病左室功能及影响因素的超声心动图研究

Study on The Left Ventricular Function And Influential Factors In Cor Pulmonale By Doppler Echocardiography.

为了探讨慢性肺心病是否有左心功能受损及其可能的机制,本文用多普勒超声心动图研究了50例肺心病患者的左室(LV)收缩和舒张功能,并讨论了左室质量(LVM)、收缩期肺动脉压(SPAP)、收缩末校正的室间隔曲率半径(CRCs)对左室SF和DF的影响。结果表明:慢性肺心病患者的左室功能普遍受损(43/50 86%),其中单纯SF、DF及二者同时受损分别占21%、46.5%、32.5%;LVM、SPAP、CRCs比对照组明显增大(P＜0.01);收缩末室间隔明显展平(凸向左室);除左室SF与SPAP几无相关外,LVM、SPAP、CRCs分别与左室SF和DF呈良好相关。结论:慢性肺心病左室功能普遍受损;LVM、室间隔移位(IVS)、右心功能受损对左室功能有明显影响;左室功能受损是多种因素共同作用的结果;慢性肺心病不是一种高输出量性心脏病,而是一种以右心排血障碍为主,左室储备功能受损的一种排血量减少的心脏病。

In order to study whether it has the left ventricular function impairment and its possible mechanisms in cor pulmonale. We evaluated the left ventricular systolic and diastolic function by doppler echocardiography in 50 cases with cor pulmonale,and discussed the influences of the LVM、SPAP、 CRCs on the LV systolic and diastolic function. The results showed that :The universal impairment of LV function in cor pulmonale (43/50,86%), Among those the simple systolic function、diastolic function and the both impairment were 21% 、46.5% 、32.5% respectively;The LVM、SPAP、CRCs in cor pulmonale group were significantly increased in compared with control group( 192 ± 43 vs 132 ± 29g、70 ±23 vs 26 ± 6m-mHg、0.71 ±0.05 vs0.62±0.06 P<0.01 respectively) ;The interventricular septum was instinct flattened (shift leftward) at the end-systolicphase; There were significantly correlation between the LVM、SPAF、CRCs and LV systolic & diastolic function respactively,excepting SPAP and systolic function has no relation. Conclusions:The LV function impaired universally in cor pulmonale; The LV hypertyophy、he IVS shift leftward at end - systolic phsae and right ventricular function impairent has a great influences upon the LV Function;The LV function impairment were the results of many factors synergistc action; The cor pulmonale was not a cardiomyopthy of higt output,but is a hypokinemia cardiomyopthy of right ejection disturbuance mainly and LV reserve func - tion impairment.