脉冲多普勒与组织多普勒技术对左室舒张功能的诊断价值

Diagnostic value of pulse doppler and tissue doppler technology in evaluating left ventricular diastolic function

目的探讨脉冲多普勒(pulse doppler,PD)与组织多普勒技术(tissue doppler technology,TDI)在评价心脏左室舒张功能方面的应用价值。方法选取武警某部医院行超声心动图检查的50例无器质性心脏病者为对照组,51例心脏病患者为研究组,应用PD测量舒张早、晚期二尖瓣血流速度峰值E峰、A峰,并计算E/A值;再应用TDI测量舒张早、晚期二尖瓣环运动速度峰值Em峰、Am峰,并计算Em/Am、E/Em值,再进行两组比较。结果研究组较对照组:E峰降低(t=2.673,P=0.012),A峰升高(t=-5.055,P=0.013),E/A降低(t=5.913,P=0.001);Em峰降低(t=14.735,P=0.002),Em/Am降低(t=24.088,P<0.05);E/Em升高(t=-8.735,P<0.05),差异具有统计学意义。结论 PD和TDI均可评价左室舒张功能,TDI较PD更准确,可以鉴别假性正常型,二者联合能更好地评价左室舒张功能。

Objective This study is aimed at discussing the value of pulse doppler （PD） and tissue doppler technology （TDI） on left ventricular diastolic function. Methods 101 patients treated with color doppler eehocardiography admitted to an armed police hospital were selected as the research subject, in which 50 patients without organic heart disease were chosen as the control group and 51 patients with cardiovascular disease as the study group. PD were performed to measure early （E-wave） and late （A-wave） diastolic mitral blood flow velocities, and E/A was calculated, TDI were performed tomeasure early （Era-wave） and late （Am-wave） mitral valve ring motion velocities, Em/Am and E/Era were calculated, and they were compared between the two groups. Results Compared with the control group, E-wave （t=2.673, P=0.012） decreased, A-wave （t=-5.055, P=0.013） increased, and E/A decreased （t=5.913, P=0.001） in the study group; Em-wave （t=14.735, P=0.002）, and Em/Am declined （t=24.088, P〈0.05） as compared with the control group; E/Era increased （t=-8.735, P〈0.05）. Conclusions PD and TDI both can provide reliable parameters to evaluate left ventricular diastolic function, but TDI is more accurate and capable of distinguishing pseudonormalized transmittal flow pattern. The combination of them can evaluate left ventricular diastolic function more precisely.