超声心动图不同技术方法评价健康志愿者左心室收缩功能的对比研究

Comparative study on left ventricular systolic function in healthy volun- teers using echocardiography

目的：比较M型超声心动图（M-mode echocardiography,MME）、二维超声心动图（two-dimensional echocardiography,2DE）、实时三维超声心动图（real-time three-dimensional echocardiography,RT-3DE）定量评价健康志愿者左心室收缩功能（left ventricular systolic function,LVSF）指标的测值大小、相关性和可重复性。方法：分别采用MME的Teichholz公式法、2DE的双平面Simpson法、RT-3DE测量31名健康志愿者左室射血分数（left ventricular ejection fraction,LVEF）和每搏量（stroke volume,SV）,并比较3种方法的测值大小、相关性和可重复性。结果：（1）MME、2DE、RT-3DE测得的射血分数（ejection fraction,EF）分别是（67.50±3.38）%、（66±3.31）%、（60.11±3.40）%,SV分别是（69.46±14.90）m L、（65.58±12.40）m L、（59.29±12.31）m L,差异均有统计学意义（P〈0.05）,EF、SV均呈递减趋势,即MME测值最大,RT-3DE测值最小;（2）3种方法测定的EF和SV相关性均好,其中MME与2DE、RT-3DE测得的EF相关系数分别为0.802、0.933;2DE与RT-3DE测得的EF相关系数为0.822;MME与2DE、RT-3DE测得的SV相关系数分别为0.901、0.689;2DE与RT-3DE测得的SV相关系数为0.735;（3）Bland-Altman图显示同1测试者前后及不同测试者之间测值均有较好的重复性。结论：3种方法均能正确评价正常健康者的LVSF,且相关性和重复性均好,其中MME测得EF和SV相对偏高,RT-3DE测得EF和SV相对偏低。

Objective： To compare the left ventricular systolic function（ LVSF） value,correlation and repeatability in healthy volunteers using M-mode echocardiography（ MME）,two-dimensional echocardiography（ 2DE） and real-time three-dimensional echocardiography（ RT-3DE）. Methods： Left ventricle ejection fraction（ LVEF） and stroke volume（ SV） were separately measured by MME Teichholz formula,2DE biplanar Simpson method,RT-3DE in 31 healthy subjects. The measuring value,correlation and repeatability were compared within the three methods above. Results：（ 1） EF was（ 67. 50 ± 3. 38） %,（ 66 ± 3. 31） %,（ 60. 11 ± 3. 40） %and SV was（ 69. 46 ± 14. 90） m L,（ 65. 58 ± 12. 40） m L,（ 59. 29 ± 12. 31） m L respectively. There were statistically significantly different in above measurements（ P 〈 0. 05）. EF and SV all showed diminishing trend,namely the parameter measured by MME was maximal but it was the opposite by RT-3D.（ 2） The correlations of EF and SV among three methods were good. The correlation coefficient of EF measured by MME with 2DE,RT-3DE was 0. 802,0. 933,the correlation coefficient by 2DE with RT-3DE was 0. 822. The correlation coefficient of SV measured by MME,2DE and RT-3DE was 0. 901,0. 689,the correlation coefficient by 2DE with RT-3DE was 0. 735.（ 3） The results showed high repeatability in intra-observer as same as inter-observer in Bland-Altman chart. Conclusion： All of the three methods can correctly evaluate LVSF in healthy subjects,meanwhile the correlation and the repeatability are good. EF and SV measured by MME is higher. On the contrary,RT-3DE is lower.