CAJ | 학술논문

目的：观察超声心动图结合组织速度成像（ TVI）技术对房颤患者左心房、左心耳功能的评价作用。方法2013年7月—2015年3月收集的房颤患者29例，根据病史分为阵发性房颤（ PAF ）组15例、持续性房颤（ PeAF）组14例，选择同时期进行食管超声检查的窦性心律患者15例为对照组。采用经胸超声心动图应用三平面TVI技术测量左心房4个壁中间段的组织速度参数；经食管超声心动图联合应用TVI技术测量左心耳8个节段的组织速度参数，对各组参数进行比较及相关性分析。结果左心房容积对照组＜PAF组＜PeAF组，左心室射血分数对照组＞PAF组＞PeAF组（ P ＜0{．05）。左心房各节段心肌收缩速度、舒张早期速度对照组＞PAF组＞PeAF组（ P ＜0．05）。与对照组相比，PAF组、PeAF组舒张峰值速度差异有统计学意义（ P ＜0．05），但PAF组及PeAF 组间舒张峰值速度差异无统计学意义（ P ＞0．05）。左心耳平均收缩峰值速度与左心房容积呈负相关（ r ＝－0．696， P ＜0．01），与左心房射血分数、平均收缩峰值速度、平均舒张早期峰值速度均呈正相关（ r ＝0．787、0．805、0．679， P均＜0．01）。结论房颤患者左心房及左心耳功能减低，持续性房颤患者更甚，左心房功能的高低对左心耳收缩功能具有预测作用，TVI技术可以较好的评价左心房及左心耳功能。
목적：관찰초성심동도결합조직속도성상（ TVI）기술대방전환자좌심방、좌심이공능적평개작용。방법2013년7월—2015년3월수집적방전환자29례，근거병사분위진발성방전（ PAF ）조15례、지속성방전（ PeAF）조14례，선택동시기진행식관초성검사적두성심률환자15례위대조조。채용경흉초성심동도응용삼평면TVI기술측량좌심방4개벽중간단적조직속도삼수；경식관초성심동도연합응용TVI기술측량좌심이8개절단적조직속도삼수，대각조삼수진행비교급상관성분석。결과좌심방용적대조조＜PAF조＜PeAF조，좌심실사혈분수대조조＞PAF조＞PeAF조（ P ＜0{．05）。좌심방각절단심기수축속도、서장조기속도대조조＞PAF조＞PeAF조（ P ＜0．05）。여대조조상비，PAF조、PeAF조서장봉치속도차이유통계학의의（ P ＜0．05），단PAF조급PeAF 조간서장봉치속도차이무통계학의의（ P ＞0．05）。좌심이평균수축봉치속도여좌심방용적정부상관（ r ＝－0．696， P ＜0．01），여좌심방사혈분수、평균수축봉치속도、평균서장조기봉치속도균정정상관（ r ＝0．787、0．805、0．679， P균＜0．01）。결론방전환자좌심방급좌심이공능감저，지속성방전환자경심，좌심방공능적고저대좌심이수축공능구유예측작용，TVI기술가이교호적평개좌심방급좌심이공능。
Objective To observe the evaluation effect of echocardiography and tissue velocity imaging (TVI) tech-nology for assessing left atrial and left atrial appendage function of atrial fibrillation patients.Methods Twenty-nine patients with atrial fibrillation collected from July 2013 to March 2015, they were divided into paroxysmal atrial fibrillation (PAF, 15 patients), persistent atrial fibrillation (PeAF, 14 patients), and 15 patients with esophageal echocardiography with sinus rhythm as controls.Using three-level TVI technique to measure the tissue velocity parameters of 4 segments of the left atrium, the tissue velocity parameters of 8 segments of the left ventricle were measured by TVI technique.Results For the left atrial volume, control group<PAF group <PeAF group, left ventricular ejection fraction were control group>PAF group >PeAF group,there were significant differences( P <0.05),myocardial systolic velocity and diastolic velocity of the left atrium were control group>PAF group >PeAF group( P <0.05).Compared with the control group, the PAF group and PeAF group’s diastolic peak velocity’s differences were statistically significant ( P <0.05), but PAF group and PeAF group’ s diastolic peak velocity differences had no statistical significance( P >0.05).Left atrial appendage average systolic blood peak velocity and left atrial volume showed a negative correlation ( r =-0.696, P <0.01), and left atrial ejection fraction, average sys-tolic peak velocity, mean diastolic peak velocity of early stage were positively correlated ( r =0.787, r =0.805, r =0.679, all P <0.01).Conclusion Patients with atrial fibrillation’s left atrium and left atrial appendage function decreased and PAF patients more obviously, the level of left atrial function can predict left atrial appendage’ s systolic function, TVI can better as-sess left atrial and left atrial appendage function.