实时三维超声技术测量肝硬化患者左心功能变化的价值

Measurement of left ventricular function in patients with liver cirrhosis at different periods by the application of real-time three-dimensional echocardiography

目的探讨实时三维超声技术(RT-3DE)对肝硬化患者左心功能变化的应用价值。方法选择2013年11月至2016年11月就诊于海安县人民医院肝硬化患者150例为观察组,选取同期在本院体检的健康者150例对照组,检测两组患者心率,应用三维超声(3DE)测定两组左心室舒张末容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)、每搏量(LVSV)、二尖瓣舒张早期峰值速度(E)、二尖瓣舒张晚期峰值速度(A)及E/A比值。结果观察组患者左心室舒张末容积[(121.34±25.74)m L]、左心室收缩末期容积[(44.26±11.54)m L]、左心室射血分数(69.10±8.02)、每搏量[(74.80±8.24)m L]与对照组[(98.32±16.34)m L、(37.42±7.24)m L、(62.21±7.63)、(69.27±6.28)m L]比较差异均无统计学意义(P>0.05);观察组患者的二尖瓣舒张早期峰值速度[(0.63±0.02)m/s]、二尖瓣舒张晚期峰值速度[(0.92±0.07)m/s]与对照组[(0.97±0.04)m/s、(0.40±0.03)m/s]比较差异均有统计学意义(P<0.05);E/A比值观察组为(0.81±0.03),与对照组的(1.89±0.02)比较差异均有统计学意义(P<0.05);观察组患者的心功能分级A、B、C级患者A指标均高于对照组,E/A均低于对照组,差异均有统计学意义(P<0.05)。结论肝硬化患者随着肝功能严重程度,E/A比值降低,肝硬化患者心脏舒张功能异常与肝功能损坏程度有关。

Objective To explore the value of real-time three-dimensional echocardiography（RT-3 DE） in thechanges of left ventricular function in patients with liver cirrhosis. Methods From November 2013 to November2016, 150 patients with cirrhosis were selected from Hai＇an County People＇s Hospital as the observation group, and150 healthy individuals were selected as the control group. Left ventricular end-diastolic volume（LVEDV）, left ven-tricular end systolic volume（LVESV）, left ventricular ejection fraction（LVEF）, stroke volume（LVSV）, mitral valve dia-stolic peak velocity（E）, left ventricular end-diastolic volume mitral valve diastolic peak velocity（A）, and E/A ratiowere detected by RT-3 DE and compared between the two groups. Heart rate（HR） was also detected and compared. Results LVEDV, LVESV, LVEF, LVSV were（121.34±25.74） m L,（44.26±11.54） m L,（69.10±8.02）,（74.80±8.24） m L inthe observation group, versus（98.32±16.34） m L,（37.42±7.24） m L,（62.21±7.63）,（69.27±6.28） m L in the control group（P〈0.05）. The E, A in the observation group were（0.63±0.02） m/s,（0.92±0.07） m/s, versus（0.97±0.04） m/s,（0.40±0.03） m/s inthe control group（P〈0.05）. The E/A ratio was（0.81±0.03） in the observation group, significantly lower than（1.89±0.02） inthe control group. The A values in the patients with cardiac functional grading A, B and C in the observation group were high-er than those in the control group, and E/A ratio was lower（P〈0.05）. Conclusion E/A ratio declines with the developmentof the severity of liver function damage. The degree of liver diastolic dysfunction is related to the degree of liver functiondamage in patients with liver cirrhosis.