实时三维超声心动图对缺铁性贫血患者左心房容积与功能的研究

Study on Left Atrial Volume and Function in Patients with Iron Deficiency Anemia by Real-time 3D Echocardiography

目的:应用实时三维超声心动图(RT-3DE)评价缺铁性贫血(IDA)患者左心房容积和功能的变化,探讨其临床应用价值。方法:60例IDA患者按照血红蛋白(Hb)浓度分为两组:A组33例Hb>90 g/L、B组27例Hb<90 g/L。健康成年人作为C组30例。脉冲多普勒测量舒张期二尖瓣口前向血流舒张早期E峰及二尖瓣环侧壁峰值速度E′,计算E/E′值。应用RT-3DE测定左心室收缩末期左心房最大容积(LAVmax)、左心室舒张末期左心房最小容积(LAVmin)、左心房主动收缩前左心房容积(LAVpre),所有测值用体表面积(BSA)校正得出LAVImax、LAVImin、LAVIpre。计算心房主动射血分数(LAAEF)、被动射血分数(LAPEF)及左心房整体射血分数(LAEF),对比分析三组结果,并对上述参数与E/E′值进行相关性分析。结果:与C组比较,B组的LAVImax、LAVImin、LAVIpre、LAAEF均显著增大(P<0.05),LAPEF、LAEF均显著降低(P<0.05),A组除LAAEF和E/E′增大外其他项指标无明显变化。而患者E/E′值与LAVImax、LAVImin、LAVIpre呈显著性正相关(P<0.05),与LAAEF、LAPEF、LAEF呈显著性负相关(P<0.05)。结论:IDA患者常具有左心房结构与功能的改变,应用RT-3DE技术可进行有效的临床评估,并可间接反映左心室舒张功能状况。

Objective：To evaluate the change of left atrial volume and function in patients with iron deficiency anemia（IDA） by real-time 3D echocardiography（RT-3DE）.Method：A total of 60 patients with IDA were selected,according to the degree of hemoglobin（Hb） ther were divided into light-level anemia（group A,Hb〉90 g/L） and middle-level anemia（group B,Hb 60-90 g/L）.Another 30 healthy people were selscted as group C.The peak flow velocity of mitral valve（E） and left ventricular lateral wall mitral annulus（E′） were measured and E/E′ was calculated.The LAmaximum volume（LAVmax）,LAminimum volume（LAVmin）,LA volume pre contraction（LAVpre） were measured by RT-3DE,then adjusted by body surfsce area（LAVImax,LAVImin,LAVIpreA）.Then LA total ejection（LAEF）,LA passive ejection fraction（LAPEF）,LA active ejection fraction（LAAEF） were calculated.Result：Compared with group C,LAVImax,LAVImin,LAVIpreA,LAAEF in group B were increased（P〈0.05）,while LAPEF,LAEF were reduced（P〈0.05）;LAAEF and E/E′ in group A was incresed（P〈0.05）,the other indexes had no obvious differences（P〉0.05）.The LAVImax,LAVImin,LAVIpre had positive correlation with E/E′（P〈0.05）,LAAEF LAPEF,LAEF had negative correlation with E/E’（P〈0.05）.Conclusion：LA function and structure are changed in IDA patients,RT-3DE can evaluate effectively patients with IDA,and indirectly reflect the change of left ventricular diastolic function.