小剂量多巴酚丁胺超声心动图对扩张型心肌病功能改变的研究

Study of Function Changes in Patients with Dilated Cardiomyopathy by Low-dose Dobutamine Shown on Echocardiograph

目的 :探讨小剂量多巴酚丁胺对扩张型心肌病功能的改变。方法 :在基础状态下及应用小剂量多巴酚丁胺超声心动图对 3 2例扩张型心肌病 (DCM )患者进行收缩和舒张功能的测定。结果 :在静息状态下 ,测定舒张功能指标 :二尖瓣舒张期血流频谱E A =3 .0± 1.4,E峰减速时间 (DT) =(12 1.3± 16.5 )ms ,等容舒张时间 (IVRT) =(5 0 .5± 11.6)ms ,肺静脉血流收缩和舒张期峰值比(S D) =0 .5 5 ,心房收缩期逆向血流速 (PA) =(3 1.1± 12 .3 )cm s。测定收缩功能指标 :射血分数 (EF) =(2 6.2± 5 ) % ,短轴收缩率(ΔD) =(13 .9± 7.3 ) % ,室间隔增厚率 (ΔIVRT) =(16.3± 6.1) %。应用多巴酚丁胺后E A明显减小 ,DT ,IVRT ,S D明显增加 ,EF值增大 ,ΔD ,ΔIVST值增加 ,二尖瓣返流量减小 ,DCM患者心肌功能均得到明显的改善。结论

Objective:To investigate the function changs in patients with dilated cardiomyopathy (DCM) by low dose dobutamine shown on echocardiograpy. Metheds: 32 cases with DCM were studied during baseline and low dose dobutamine infusion by echocardiography. Results: In baseline, the indexes of the diastolic functoin are E/A=3.0±1.4, DT=(121.3±6.5)ms, IVRT=(50.5±11.6)ms. The pulmonary venous systolic to diastolic flow ratio was 0.55. Revesed pulmonary venous flow at atrial systole (PA) was (31.1±12.3)cm/s. The indexes of the systolic function are EF=(26.2±5)%, ΔD=(13.9±7.3)%, ΔIVST=(16.3±6.1)%. After dobutamine infusion , E/A ratio and PA decreased, and DT? IVRT?EF?ΔD and ΔIVST increased signficantly. The systolic and distolic functions of the 32 cases with DCM were significantly improved. Conclusion: The left ventricular systolic and diastolic in the patients with DCM can be improved by low dos dobutamine.