超声心动图无创测定心功能力学参数的新指标

Noninvasive measuring the new indexes of cardiac functions by echocardiography

目的 通过超声心动图实现无创测定心肌梗死患者心功能力学参数的方法并探讨这些指标的诊断价值。方法 利用心脏超声、心音图及心电图同屏幕显示和同步监测血压技术 ,记录不同梗死部位和面积的心肌梗死患者在给药前后不同血压时的左室舒缩末期长短径、室壁厚度和血压值。经计算机程序处理 ,求得最大弹性模量 (Emax)、最大心肌劲度 (maxEav)和射血分数 (EF)值。结果 按梗死部位的不同 ,心肌梗死患者的Emax、maxEav和EF值大小依次是对照组 >下壁梗死组 >前壁梗死组 >多壁梗死组 ;按梗死面积的不同 ,心肌梗死患者的Emax、maxEav和EF值依次是对照组 >小面积组 >大面积组 ;而且梗死部位与Emax关系密切 ,梗死面积与maxEav相关性更好 ,梗死部位和梗死面积与EF值的相关无特异性。结论 借助超声心动图建立的无创测定心功能力学参数Emax和maxEav对不同梗死部位和面积的心肌梗死患者有特殊诊断价值。

Objective To establish the method of noninvasive measuring the new indexes of cardiac functions by echocardiography and illustrate the diagnostic values of the indexes.Methods By use of simultaneous screen display of echocardiography, phonocardiography and electrocardiography and synchronously monitoring blood pressure (BP) technique, the values of LV end systolic and end diastolic long and short axis dimensions, wall thickness and area sizes,and synchronous BP were measured in the patients with myocardial infarction (MI) of defferent sites and area sizes before and during BP were altered to defferent degrees. The values of maximum elasticity (E max ) and average maximum myocardial elasticity stiffness ( max Eav) and ejection blood fraction (EF) were calculated through computer programmed process.Results The order of values of E max , max Eav and EF among MI patients of defferent sites was control group>inferior MI group>anterior MI subgroup>multi wall MI subgroup. Their order among MI patients of defferent area sizes was control group > small area MI subgroup > larger MI subgroup. E max was associated with the MI parts and max Eav was associated better with the MI area sizes.Conclusions The study has established a noninvasive method of examining cardiac function by use of echocardiography and reflected the special diagnostic values of E max , max Eav and EF in MI patients of defferent parts and area sizes.