双通道多普勒技术评价扩张型心肌病患者左心室功能的价值

Evaluation of left ventricular function in patients with dilated cardiomyopathy by Dual pulse-wave Doppler technique

目的：探讨双通道多普勒法（DPW）评价扩张型心肌病患者心功能的应用价值。方法：选择已经临床确诊的DCM患者30例作为病例组,随机抽取40例健康人作为对照组进行研究,每位患者均行常规超声心动图检查,测量二尖瓣舒张早期峰值流速（E峰）和舒张晚期峰值流速（A峰）,并采用双通道多普勒法和传统方法分别获得左心室Tei指数和舒张早期二尖瓣血流峰值流速（E）与彩色M型舒张早期血流传播速度（Vp）比值（E/Vp）,观察对比分析各组心脏结构及心功能参数的差异性。结果：病例组两种方法测得Tei指数和E/Vp均高于对照组,差异有统计学意义（P均＜0.01）。与传统方法相比,DPW法测的Tei指数和E/Vp均增大（P均＜0.01）。病例组DPW法和传统法测量Tei指数与LVEF均呈负相关,相关性为r=-0.781,-0.705,P〈0.01。当DPW法测量E/Vp≥1.33时,E/Vp诊断左心室舒张功能不全的ROC曲线下面积为0.92,大于传统法测量E/Vp。（3）结论：双通道多普勒超声成像技术测量Tei指数及E/Vp不受心律的影响,可作为准确敏感评估DCM患者左心室功能的指标。

Objective： Explore the application value of Dual pulse-wave Doppler in evaluating left ventricular function of patients with dilated cardiomyopathy（DCM）. Method：40 healthy persons served as a control group and 30 DCM patients served as study group in this study. Conventional echocardiography performed in all patients, then E and A were measured. The Dual pulse-wave Doppler and the traditional method were used to obtain the Tei index and E/Vp of left ventricular. Then we observed and compared the difference in the cardiac structures and systolic function parameters. Results： The Tei index and E/Vp of the two methods in the DCM group were higher than those in the normal group, the differences were statistically significant（all P＜0.01）.Compared with the traditional method,the Tei index and the E/Vp measured by the DPW method are both increased（all P＜0.01）. Both Tei index measured by DPW and traditional method had a negative correlation with LVEF（-0.781,-0.705,P〈0.01） .When the synchronous E/Vp≥1.33,area under the ROC curve in diagnosis of left ventricular diastolic function was 0.92,which is larger than the non-synchronous E/Vp. Conclusion： Tei index and E/Vp measured by Dual pulse-wave Doppler technique is not affecte by the rhythm of the heart. They can be used as an accurate and sensitive index to evaluate left ventricular function in patients with DCM.