CAJ | 학술논문

目的应用实时三维超声心动图评价心脏移植排异组及无排异组的左右心室功能的变化.方法对14例心脏移植排异患者、24例心脏移植无排异患者和51例正常者进行二维及实时三维超声心动图检查.结果心脏移植排异组、无排异组右室每搏输出量(RVSV)及右室射血分数(RVEF)均小于正常对照组(P均<0.05),而右室舒张末期容积及收缩末期容积与正常对照组比较差异无统计学意义(P均>0.05);心脏移植无排异组与排异组间RVSV、RVEF、右室舒张末期容积及收缩末期容积比较差异无统计学意义(P均>0.05).心脏移植排异组17节段时间-容积曲线参数指标:16节段、12节段、6节段达到最小收缩容积时间的标准差以及标准差的校正值(Tmsv 16-SD,Tmsv 16-SD%,Tmsv 12-SD,Tmsv 12-SD%,Tmsv 6-SD,Tmsv 6-SD%)以及16节段、12节段、6节段达到最小收缩容积时间的最大差值以及最大差值的校正值(Tmsv 16-Dif,Tmsv 16-Dif%,Tmsv 12-Dif,Tmsv 12-Dif%,Tmsv 6-Dif,Tmsv 6-Dif%)均高于正常对照组(P均<0.05);心脏移植排异组与无排异组比较,除Tmsv 16-SD,Tmsv 16-SD%的指标差异无统计学意义外(P>0.05),其余17节段参数指标均高于无排异组(P均<0.05);而心脏移植无排异组17节段时间-容积曲线参数指标与正常对照组比较差异均无统计学意义(P均>0.05).位移平均值、标准差、最大值、最小值在心脏移植排异组、无排异组及正常对照组之间比较,差异均无统计学意义(P均>0.05).结论实时三维超声心动图能快速、准确地评价心脏移植术后排异组及无排异组的左右心室功能的变化.
목적 응용실시삼유초성심동도평개심장이식배이조급무배이조적좌우심실공능적변화.방법 대14례심장이식배이환자、24례심장이식무배이환자화51례정상자진행이유급실시삼유초성심동도검사.결과 심장이식배이조、무배이조우실매박수출량(RVSV)급우실사혈분수(RVEF)균소우정상대조조(P균<0.05),이우실서장말기용적급수축말기용적여정상대조조비교차이무통계학의의(P균>0.05);심장이식무배이조여배이조간RVSV、RVEF、우실서장말기용적급수축말기용적비교차이무통계학의의(P균>0.05).심장이식배이조17절단시간-용적곡선삼수지표:16절단、12절단、6절단체도최소수축용적시간적표준차이급표준차적교정치(Tmsv 16-SD,Tmsv 16-SD%,Tmsv 12-SD,Tmsv 12-SD%,Tmsv 6-SD,Tmsv 6-SD%)이급16절단、12절단、6절단체도최소수축용적시간적최대차치이급최대차치적교정치(Tmsv 16-Dif,Tmsv 16-Dif%,Tmsv 12-Dif,Tmsv 12-Dif%,Tmsv 6-Dif,Tmsv 6-Dif%)균고우정상대조조(P균<0.05);심장이식배이조여무배이조비교,제Tmsv 16-SD,Tmsv 16-SD%적지표차이무통계학의의외(P>0.05),기여17절단삼수지표균고우무배이조(P균<0.05);이심장이식무배이조17절단시간-용적곡선삼수지표여정상대조조비교차이균무통계학의의(P균>0.05).위이평균치、표준차、최대치、최소치재심장이식배이조、무배이조급정상대조조지간비교,차이균무통계학의의(P균>0.05).결론 실시삼유초성심동도능쾌속、준학지평개심장이식술후배이조급무배이조적좌우심실공능적변화.
Objective To evaluate left and right ventricular function by real-time three-dimensional echocardiography in patients with heart transplantation.Methods Fourteen patients with heart transplantation ( rejection)[12 male,2 female,mean age (49.21±17.91)],twenty four patients with heart transplantation (no rejection) [21 male,3 female,mean age (40.11±12.57)],and fifty one subjects with normal left ventricular function [26 male,25 female,mean age (43.69±14.81) ] were examined by Philips iE33 with a X3-1 probe.Results Right ventricular stroke volume (RVSV) and right ventricular ejection fraction (RVEF) in heart transplantation (including no rejection and rejection) was reduced compared with subjects with normal heart function (all P<0.05),but right ventricular end-diastolic volume (RVEDV) and right ventricular end-systolic volume (RVESV) were no significantly different between heart transplantation and subjects with normal heart function (all P>0.05),but the volume and function of right ventricle were no significantly different between rejection heart transplantation and no rejection heart transplantation.Parameter index of 17 segment including standard deviation (SD) and maximum difference(Dif) of 16,12 and 6 segment time to minimal systolic volume(Tmsv 16-SD,Tmsv 16-Dif,Tmsv 12-SD,Tmsv 12-Dif,Tmsv 6-SD,Tmsv 6-Dif),and the percent of SD and maximum difference 16,12 and 6 segment time tominimal systolic volume [Tmsv 16-SD(%),Tmsv 16-Dif(%),Tmsv 12-SD(%),Tmsv 12-Dif(%),Tmsv 6-SD(%),Tmsv 6-Dif(%)] was significantly higher in patients with heart transplantation (rejection) than that in subjects with normal heart function and in patients with heart transplantation (no rejection)[except Tmsv 16-SD and Tmsv 16-SD(%),other P<0.05],however,there was no significantly different between heart transplantation (no rejection) and subjects with normal heart function(all P>0.05).But also average,maximum and minimum value of excursion in three groups was no significantly different (all P>0.05).Conclusions Real-time three-dimensional echocardiography can rapidly and acurately evaluate left and right ventricular function in patients with heart transplantation.