三维超声心动图估测左心室型单心室心功能的临床研究

Assessment of globe and segmental heart function in children with single left ventricle by three dimensional echocardiography

目的探讨三维超声心动图评估左心室型单心室患儿的整体心功能及局部心功能的准确性。方法 36例左心室型单心室患儿为病例组,36例正常儿童为对照组,应用Q-lab软件分析并计算左心室型单心室主心腔及正常儿童左心室的舒张末期容积(EDV)、收缩末期容积(ESV)、射血分数(EF)、17节段局部ESV、EDV和EF。结果病例组的EDV、ESV明显大于对照组(P<0.05)。病例组的EF明显小于对照组(P<0.05)。除前间隔基底段、后间隔基底段、前壁心尖段及心尖段心尖部无统计学差异外,病例组其余节段局部ESV均大于对照组(P<0.05)。病例组前壁基底段、后间隔基底段、后壁基底段、后侧壁基底段、前间隔中间段及后壁中间段节段EDV均大于对照组(P<0.05)。病例组除后间隔基底段外,局部EF均小于对照组(P<0.05)。结论左心室型单心室患者存在整体心功能不全及局部心功能不全,实时三维超声心动图可准确地反映左心室型单心室患者整体及局部心功能。

Objective To explore the accuracy of three-dimensional echocardiography(3DE)for assessment of globe and segmental heart function in single left ventricle.Methods Seventy-two subjects were divided into two groups,36 healthy children and 36 patients with single left ventricle were enrolled in this study.There were no significant difference in age,sex,heart rate between the two groups.3DE data was acquired with the IE 33 system,and then analyzed by Q-lab software.End-diastolic volume(EDV),end-systolic volume(ESV)and eject fraction(EF)and volumes of each segment were acquired by 3DE.Results There were significant difference in EDV,ESV and EF between healthy volunteers and patients with single left ventricle(P<0.05).The regional end-systolic of most segments except basal anteroseptal,basal inferoseptal and apex in patients with single left ventricle were significantly higher than those in the control group(P<0.05).The regional end-diastolic of basal anterior,basal inferoseptal basal lateral,basal inferolateral,basal anterolateral,mid anteroseptal and mid inferior end-systolic volume were significantly higher than those in the control group(P<0.05).Besides basal inferoseptal,the regional fraction(REF)of most segments in patients with single left ventricle decreased significantly compared with corresponding segments in the control group(P<0.05).Conclusions Poorer globe and segmental ventricular function were found in patients with single left ventricle,and could be assessed accurately by 3DE.