CAJ | 학술논문

目的：采用经食管三维超声心动图（RT 3D-TEE）技术结合小剂量多巴酚丁胺，分析缺血性二尖瓣反流患者和正常对照者的二尖瓣几何形态学参数在静息及负荷状态时的变化特点。方法采用 MVQ 技术对25例缺血性心二尖瓣反流组患者及20名正常对照者组进行检查，应用 MVQ 软件测量并分析对照组及缺血性二尖瓣反流组患者在静息及使用小剂量多巴酚丁胺后二尖瓣环及瓣叶几何形态学参数变化特点。结果正常对照组二尖瓣环及瓣叶结构相对稳定，并不随小剂量多巴酚丁胺的使用而发生明显变化；对缺血性二尖瓣反流组患者使用多巴酚丁胺，二尖瓣环及瓣叶空间结构变化主要体现在瓣环结构的构型变化及由其产生的二尖瓣瓣叶对合参数的变化；小剂量多巴酚丁胺的使用后二尖瓣环构型相对朝向正常“鞍状”结构的回归。结论小剂量负荷时缺血性二尖瓣反流程度的减少依赖于左心功能相对增加后二尖瓣环构型相对朝向正常“鞍状”结构的回归，二尖瓣的帆状穹窿构型变化在保证二尖瓣环及瓣叶结构稳定性中起着至关重要的作用。
목적：채용경식관삼유초성심동도（RT 3D-TEE）기술결합소제량다파분정알，분석결혈성이첨판반류환자화정상대조자적이첨판궤하형태학삼수재정식급부하상태시적변화특점。방법채용 MVQ 기술대25례결혈성심이첨판반류조환자급20명정상대조자조진행검사，응용 MVQ 연건측량병분석대조조급결혈성이첨판반류조환자재정식급사용소제량다파분정알후이첨판배급판협궤하형태학삼수변화특점。결과정상대조조이첨판배급판협결구상대은정，병불수소제량다파분정알적사용이발생명현변화；대결혈성이첨판반류조환자사용다파분정알，이첨판배급판협공간결구변화주요체현재판배결구적구형변화급유기산생적이첨판판협대합삼수적변화；소제량다파분정알적사용후이첨판배구형상대조향정상“안상”결구적회귀。결론소제량부하시결혈성이첨판반류정도적감소의뢰우좌심공능상대증가후이첨판배구형상대조향정상“안상”결구적회귀，이첨판적범상궁륭구형변화재보증이첨판배급판협결구은정성중기착지관중요적작용。
Objective To investigate the clinical value of mitral valve quantitative (MVQ) software selecting the significant parameters in diagnosing ischemic mitral regurgitation (IMR) and analyze the mechanism of mural valve regurgitation by MVQ in clinical. Methods Real-time three-dimensional transesophageal echocardiography (RT 3D-TEE) was performed on forty-five patients, in which 25 patients with ischemic mitral regurgitation, another 20 patients without mural valve regurgitation regarded as control group. The images were stored and processed with MVQ soft ware off line. Parameters of mural valve structure were measured in mitral valve 3D mode. Results The results showed the normal subjects tends to keep the relative stable structure and geometry on mitral-leaflets and annular both at the rest condition and dobutamine infusion. Conclusion The structure and geometry of mitral-leaflets and annular in patients with obvious IMR would change especial on the annular structure and leaflets competence; It would cause the regression towards the saddle structure with low-dose dobutamine.