超声心动图评价双腔起搏器患者左室舒张功能的初步研究

Echocardiographic Evaluation of Left Ventricular Diastolic Function in DDD Pacemaker Patient

目的:探讨超声心动图在双腔起搏器植入患者左室舒张功能评估中的作用。方法:研究对象为2007年5月至2010年7月某院收治的42例行双腔起搏器植入术的患者,在术前、术后3个月和6个月均行超声心动图检测,观察左心室舒张功能各项指标,包括二尖瓣口舒张早期血流速度(E)、二尖瓣舒张晚期血流速度(A)、E峰减速时间(DT)、等容舒张时间(IVRT)、二尖瓣环舒张早期峰值流速(Em)、左房容积指数(LAVI)的变化。结果:在左心室舒张功能各项指标中,术后6个月E值为(62.5±6.8)cm/s,显著(P<0.05)低于术前E值(81.2±8.9)cm/s;术后6个月A值为(75.3±9.5)cm/s,显著(P<0.05)高于术前A值(67.1±10.2)cm/s;术后6个月DT值为(194.5±12.6)ms,显著(P<0.05)高于术前DT值(171.2±10.8)ms;术后6个月IVRT值为(110.8±11.7)ms,显著(P<0.05)高于术前IVRT值(95.8±9.9)ms;Em值术前、术后无显著改变(P>0.05);术后6个月LAVI值为28.4±7.3,显著(P<0.05)低于术前IVRT值33.6±5.4。结论:超声心动图具有操作简单、无创的优点,应用于对行双腔起搏器植入术患者的左室舒张功能的评估,其诊断价值高,值得临床上推广应用。

Objective To investigate the effects of left ventricular diastolic function on the degenerative disc disease（DDD） pacemaker patients. Methods Forty-two patients with DDD pacemakers hospitalized during May 2007 and July 2010 underwent the echocardiography examinations three and six months before and after the operation. The indexes for left ventricular diastolic function were observed, including early diastolic transmitral velocity（E）, late diastolic transmitral velocity（A）, E deceleration time（DT）, isovolumic relaxation time（IVRT）, early diastolic mitral annulus peak velocity（Era） and left arterial volume index. Results The value of E was（62.5＋6.8） cm/s 6 months after the operation, significantly lower than that before the operation, （81.2＋8.9） cm/s, with P〈0.05. The value of A was（75.3＋9.5） cm/s, significantly higher than that before the operation, （67.1＋10.2） cm/s, with P〈0.05. The value of DT was（194.5＋12.6） ms, significantly higher than that before the operation, （171.2＋10.8） ms. The value of IVRT was（110.8＋11.7） ms, significantly higher than that before the operation, （95.8＋9.9） ms. The value of LAVI was 28.4＋7.3, significantly lower than that before the operation, 33.6＋5.4, with P〈0.05. There was no significant difference between the values of Em before and after the operation, with P〉0.05. Conclusion Echocardiography, being easy and non-invasive, can be used to evaluate the effects of left ventricular diastolic function on the degenerative disc disease （DDD） pacemaker patients, and is worth popularizing elinically.