实时三维超声心动图评价房间隔缺损患者的左心室功能研究

Assessment of left ventricular systolic function in patients with atrial septal defect by real-time three dimensional echocardiography

目的应用实时三维超声心动图(RT-3DE)技术评价房间隔缺损(ASD)患者左心容积、功能。方法 32例完成治疗(封堵或修补)的ASD患者(ASD组,治疗前及治疗后)及30名健康志愿者(NOR组)作为研究对象。NOR组及ASD组(术前一周内、术后15d)行常规及RT-3DE检查,对三维图像进行容积参数分析,分析参数包括:左心室舒张末容积(LVEDV)、左心室收缩末容积(LVESV)、左心室每搏量(LVSV)、左心室射血分数(LVEF)。结果 ASD组治疗前LVEDV、LVESV、LVSV低于NOR组(P<0.05),LVEF与NOR组无统计学差异;治疗后与治疗前比较:LVEDV、LVESV、LVSV明显增大,差异有统计学意义(P<0.05),LVEF无统计学差异;治疗后LVEDV、LVESV、LVSV、LVEF与NOR组比较:无统计学差异(P>0.05)。结论 ASD患者治疗前左心容量较正常人减低,但左心室心肌收缩功能正常,治疗后左心容量恢复正常;RT-3DE评价左心容积、功能具有独特优势。

Objective To investigate left ventricular systolic function before and after operation in atriel septal defect （ ASD ） patients by real-time three dimensional eehocardiography. Methods Thirty-two samples of complete secundum ASD patients with complete closure or repair of ASD patients （ASD group, preoperative and postoperative）and thirty normal subjects served as the control. Real-time three dimensional echocardiography（ RT- 3DE） was performed on all subjects to obtain and analyze parameters as follows ：left ventricular end-diastolic volume （ LVEDV）, Left ventricular end-systolic volume （ LVESV ）, Left ventricular stroke volume （ LVSV ） , Left ventricular ejection fraction （LVEF）. Results The LVEDV, LVESV, LVSV of the ASD patients before treatment were lower than that of the after treatment（ P 〈 0. 05 ） , but LVEF had no significant difference （ P 〉 0. 05 ）. After treatment the LVEDV, LVESV, LVSV, LVEF had no significant difference between the ASD group and the NOR group（ P 〉 0. 05 ）. Conclusions The volume of left ventricular in ASD patients decrease,but systolic function is normal. The volume of left ventrieular in ASD patients are reeoverd after treating. RT-3DE has an unique advantage in the evaluation of the left ventrieular volume and systolic function.