RT-3DE评估冠心病患者左心房功能临床价值研究

Rt-3de to evaluate the clinical value of left atrial function in patients with coronary heart disease

目的:实时三维超声心动图(real-time three dimensional echocardiography,RT-3DE)评估冠心病患者左心房功能临床价值研究。方法:选取体检正常者20例为对照组,56例根据冠脉造影确诊为冠心病的患者为病例组,根据冠状动脉病变支数不同分为单支病变(A组)、双支病变(B组)、三支病变(C组),用二维超声心动图与RT-3DE对四组人员分别进行检查,测量左房前后径((Left Atrial Diameter,LAD)、左房最小容积(Left atrial minimum volume,LAVmin)、左房最大容积(left atrial Maximum volume,LAVmax)、和左房整体射血分数(Left atrial ejection fraction,LAEF)、二维频谱多普勒测量舒张期二尖瓣口E峰、A峰、E/A。结果:①正常组和冠心病组组内比较,二维与RT-3DE测量结果比较差异无显著性意义(P>0.05);②正常组与冠心病组组间比较,二维测量结果、RT-3DE测量值各自对比差异有显著性意义(P<0.05),且B组和C组LAD、LAVmin、LAVmax明显大于正常组和A组,而LAEF则明显减低;③三维测量的LAEF和二维的E/A及三维测得的LAEF3D与二维测得的LAEF2D有显著的正相关关系(r=0.81,r=0.89)。结论:冠心病会影响左心房的功能,随着冠心病程度的加重而加重;RT-3DE比二维更能准确测量冠心病患者左房不同时期的容积,评价其功能,进一步为观察冠心病左心房容量与功能的变化提供新的检测方法。

Objective:To investigate the clinical value of real-time three-dimensional echocardiography(RT-3DE)in assessing left atrial function in patients with coronary heart disease.Methods:Fifty-six patients with coronary heart disease confirmed by coronary angiography in the First Affiliated Hospital of Jiamusi University were selected as the case group,and 20 healthy patients were selected as the control group.According to the number of coronary artery lesions,the case group was divided into single-branch lesions(group A),double-branch lesions(group B)and three-branch lesions(group C).Two-dimensional echocardiography and RT-3DE were used to investigate the left anterior and posterior diameter(LAD),left atrial minimum volume(LAVmin),left atrial maximum volume(LAVmax)and left atrial global ejection fraction(LAEF),and the values of peak E,peak A and E/A at the mitral valve orifice in diastolic phase were measured by two-dimensional spectral Doppler.Results:There was no statistically significant difference between the four groups(P>0.05).Comparison between groups showed that LAD,LAVmin and LAVmax in group B and C were significantly greater than those in control group and Group A,while LAEF was significantly smaller than those in control group and group A,with statistically significant differences(P<0.05).The LAEF3D of three-dimensional measurement has A significant positive correlation with the E/A and LAEF2D of two-dimensional measurement(r=0.81,r=0.89).Conclusion:Coronary heart disease can affect the function of left atrium,and the aggravation of coronary heart disease also increases.Rt-3de can more accurately measure the volume of left atrium at different stages in patients with coronary heart disease than two-dimensional detection,and it is an effective detection method to evaluate the function of left atrium.