中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2009年
7期
1164-1169
,共6页
崔嘉萍%刘兰燕%赵金惠%赵真%孙静
崔嘉萍%劉蘭燕%趙金惠%趙真%孫靜
최가평%류란연%조금혜%조진%손정
心肌病,扩张型%超声心动描记术,多普勒%主动脉
心肌病,擴張型%超聲心動描記術,多普勒%主動脈
심기병,확장형%초성심동묘기술,다보륵%주동맥
Cardiomyopathy,dilated%Echocardiography,Doppler%Aorta
目的 探讨扩张型心肌病(DCM)患者主动脉弹性改变.方法 DCM患者33例,健康志愿者30例.所有受试者肱动脉血压测量之后即刻左侧卧位,连接心电图,行常规经胸超声心动图检查.M型超声分别测量升主动脉瓣上3 cm处收缩期和舒张期内径,利用公式计算主动脉膨胀性(D)和僵硬度(β).转入TVI模式在组织-速度曲线上测量升主动脉同处前壁的运动速度(Sao).改良Simpson法测定左室射血分数(LVEF).结果 DCM组僵硬度增高(3.38±0.72 vs.1.83±0.47,P<0.01),膨胀度降低[(0.70±0.18)cm2/dynes vs.(1.24±0.32)cm2/dynes,P<0.01],升主动脉前壁S波运动速度降低[(4.40±0.69)cm/s vs.(6.45±1.29)cm/s,P<0.01],差异均有统计学意义.DCM组与对照组中,年龄与主动脉僵硬度呈正相关(均P<0.05),与主动脉前壁S波速度和主动脉膨胀性呈负相关(均P<0.05);在DCM组,LVEF是主动脉前壁S波速度的另一重要影响因素(P<0.01).结论 DCM患者主动脉弹性功能受损;年龄及左室射血功能是DCM患者主动脉弹性受损的重要影响因素.
目的 探討擴張型心肌病(DCM)患者主動脈彈性改變.方法 DCM患者33例,健康誌願者30例.所有受試者肱動脈血壓測量之後即刻左側臥位,連接心電圖,行常規經胸超聲心動圖檢查.M型超聲分彆測量升主動脈瓣上3 cm處收縮期和舒張期內徑,利用公式計算主動脈膨脹性(D)和僵硬度(β).轉入TVI模式在組織-速度麯線上測量升主動脈同處前壁的運動速度(Sao).改良Simpson法測定左室射血分數(LVEF).結果 DCM組僵硬度增高(3.38±0.72 vs.1.83±0.47,P<0.01),膨脹度降低[(0.70±0.18)cm2/dynes vs.(1.24±0.32)cm2/dynes,P<0.01],升主動脈前壁S波運動速度降低[(4.40±0.69)cm/s vs.(6.45±1.29)cm/s,P<0.01],差異均有統計學意義.DCM組與對照組中,年齡與主動脈僵硬度呈正相關(均P<0.05),與主動脈前壁S波速度和主動脈膨脹性呈負相關(均P<0.05);在DCM組,LVEF是主動脈前壁S波速度的另一重要影響因素(P<0.01).結論 DCM患者主動脈彈性功能受損;年齡及左室射血功能是DCM患者主動脈彈性受損的重要影響因素.
목적 탐토확장형심기병(DCM)환자주동맥탄성개변.방법 DCM환자33례,건강지원자30례.소유수시자굉동맥혈압측량지후즉각좌측와위,련접심전도,행상규경흉초성심동도검사.M형초성분별측량승주동맥판상3 cm처수축기화서장기내경,이용공식계산주동맥팽창성(D)화강경도(β).전입TVI모식재조직-속도곡선상측량승주동맥동처전벽적운동속도(Sao).개량Simpson법측정좌실사혈분수(LVEF).결과 DCM조강경도증고(3.38±0.72 vs.1.83±0.47,P<0.01),팽창도강저[(0.70±0.18)cm2/dynes vs.(1.24±0.32)cm2/dynes,P<0.01],승주동맥전벽S파운동속도강저[(4.40±0.69)cm/s vs.(6.45±1.29)cm/s,P<0.01],차이균유통계학의의.DCM조여대조조중,년령여주동맥강경도정정상관(균P<0.05),여주동맥전벽S파속도화주동맥팽창성정부상관(균P<0.05);재DCM조,LVEF시주동맥전벽S파속도적령일중요영향인소(P<0.01).결론 DCM환자주동맥탄성공능수손;년령급좌실사혈공능시DCM환자주동맥탄성수손적중요영향인소.
Objective To evaluate factors which influence the elasticity of the proximal aorta in patients with dilated cardiomyopathy (DCM).Methods Thirty-three patients with DCM were selected,while 30 healthy volunteers were matched with DCM group in age and gender as control group.After measuring arterial pressure,all subjects were immediately examined by using conventional echocardiography at left lateral decubitus position and linking ECG at the same time.In addition,internal aortic systolic and diastolic diameters were obtained at 3 cm above the aortic valve with M-mode echocardiography.As a result,aortic distensibility (cm2/dynes) and aortic stiffness index were calculated by using formulas.In the view of ascending aortic tissue velocity imaging (TVI),ascending aortic upper wall tissue velocities (aortic S,cm/s) were measured 3 cm above the aortic valve (the same point as the former) on TVI curve.And left ventricular ejection fraction (LVEF) was calculated by modified Simpson's method.Results Compared to the healthy subjects,the aortic stiffness index of patients with DCM was significantly higher (3.38±0.72 vs.1.83±0.47,P<0.01),while aortic distensibility and aortic S velocity were significantly lower respectively [(0.70±0.18)cm2/dynes vs.(1.24±0.32)cm2/dynes,P<0.01,(4.40±0.69)cm/s vs.(6.45±1.29)cm/s,P<0.01].For both DCM group and healthy group,positive correlation was found between age and aortic stiffness (P<0.05,both),and age was found to have significantly negative correlation with aortic S wave velocity and left ventricle ejection (P<0.05,both).Furthermore,in DCM group,left ventricle ejection was the other important factor which has influence on aortic S wave velocity.Conclusions Elasticity of aorta in patients with DCM has been damaged.Age and left ventricle ejection are the important clinical factors which would acceletate the process of reducing the elasticity of aorta in patients with DCM.
