RT-3DE评价CABG术后左室整体及节段收缩功能的应用价值
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摘要
目的应用实时三维超声心动图(RT-3DE)评价冠状动脉旁路移植术(CABG)术后左室收缩功能改变。方法选择行CABG的冠心病患者45例为研究对象,均将移植动脉与左前降支(LAD)及右冠状动脉(RCA)行远端侧吻合,另外选取30例健康人为对照。采用RT-3DE测量两组左室整体及LAD、RCA供血节段舒张末容积(LVEDV、rEDV)、收缩末容积(LVESV、rESV)、射血分数(LVEF、rEF)。结果 CABG组患者术后LVEDV、LVESV较术前降低(P<0.05),LVEF较术前升高(P<0.05)。LAD供血315节段术后rEDV、rESV与术前相比降低(P<0.05),rEF与术前相比升高;RCA供血225节段rEDV、rESV与对照组相比升高(P<0.05),rEF与对照组相比降低(P<0.05)。结论 RT-3DE评估冠心病患者CABG术后左室功能的改变,对冠心病患者的病情的发展、治疗效果及预后具有重要的临床意义。
Objective To evaluate the changes of left ventricular systolic function after coronary artery bypass grafting(CABG)using the real-time three-dimensional echocardiography(RT-3DE).Methods Fortyfive patients with coronary heart disease(CHD)undergoing CABG were selected as the study subjects.The grafted vessels were performed the distal end-to-side anastomosis with the left anterior descending(LAD)and right coronary artery(RCA).Other 30 healthy persons were selected as the controls.The left ventricular overall and segment end-diastolic volume(LVEDV,rEDV),end-systolic volume(LVESV,rESV)and ejection fraction(LVEF,rEF)of left ventricle overall and LAD,RCA blood supply segment in the CABG group and control group were measured by RT-3DE.Results LVEDV and LVESV in the CABG group decreased compared with those before operation(P<0.05),and LVEF increased compared with the preoperation(P<0.05);rEDV and rESV of the bypass blood supply segment were reduced compared with the preoperation(P<0.05),while rEF increased compared with preoperation(P<0.05);rEDV and rESV in the bypass vascular blood supply segment 225 increased compared with those in the control group(P<0.05),and rEF decreased compared with that in the control group(P<0.05).Conclusion RT-3DE for evaluating the change of left ventricular function in the CHD patients with CABG has an important clinical significance for the disease development,treatment effect and prognosis of patients with CHD.
Objective To evaluate the changes of left ventricular systolic function after coronary artery bypass grafting(CABG)using the real-time three-dimensional echocardiography(RT-3DE).Methods Fortyfive patients with coronary heart disease(CHD)undergoing CABG were selected as the study subjects.The grafted vessels were performed the distal end-to-side anastomosis with the left anterior descending(LAD)and right coronary artery(RCA).Other 30 healthy persons were selected as the controls.The left ventricular overall and segment end-diastolic volume(LVEDV,rEDV),end-systolic volume(LVESV,rESV)and ejection fraction(LVEF,rEF)of left ventricle overall and LAD,RCA blood supply segment in the CABG group and control group were measured by RT-3DE.Results LVEDV and LVESV in the CABG group decreased compared with those before operation(P<0.05),and LVEF increased compared with the preoperation(P<0.05);rEDV and rESV of the bypass blood supply segment were reduced compared with the preoperation(P<0.05),while rEF increased compared with preoperation(P<0.05);rEDV and rESV in the bypass vascular blood supply segment 225 increased compared with those in the control group(P<0.05),and rEF decreased compared with that in the control group(P<0.05).Conclusion RT-3DE for evaluating the change of left ventricular function in the CHD patients with CABG has an important clinical significance for the disease development,treatment effect and prognosis of patients with CHD.
引文
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[3]熊思,罗长军,潘永寿,等.实时三维超声心动图协助评价左前降支PCI术后左心室功能的逆转[J].心血管病防治知识,2016(1):73-74.
[4]张小花,韩素华,门光明,等.实时三维超声心动图对左前降支经皮冠状动脉介入术后左室节段收缩功能与同步性的评价[J].临床超声医学杂志,2016,18(8):517-520.
[5]白雪.实时三维超声评价不稳定型心绞痛患者支架植入前后左心室功能[D].天津:天津医科大学,2016.
[6]赵盈洁,潘翠珍,孔德红,等.实时三维超声心动图评价二尖瓣狭窄经皮球囊扩张术后左右心功能变化[J].中华临床医师杂志,2016,10(15):2236-2240.
[7]宋玲玲,叶雪存.实时三维超声心动图评价冠心病室壁运动幅度及舒张功能[J].医疗装备,2016,29(22):18-19.
[8]孙文兵,李秀兰,丁波,等.实时三维超声评价心肌梗死患者介入术后心脏整体及局部收缩功能[J].检验医学与临床,2016,13(18):2599-2601.
[9]谢朝阳.实时三维超声心动图在评价心肌梗死患者PCI术后心脏整体及局部收缩功能中的应用[J].中国民康医学,2018,30(11):27-28.
[10]王伟芳,郝宏,丁智超.三维和二维超声心动图评估心肌梗死患者左心室功能和心肌梗死范围的比较[J].河北医学,2018,24(9):1532-1537.
[11]李靖,高敬.实时三维超声心动图评价心肌梗死患者左心房功能[J].中国心血管杂志,2017,22(3):182-185.
[12]谢广平.实时三维超声显像对心肌梗死左心室收缩功能的分析[J].饮食保健,2017,4(11):234.
[13]林瑜芬,李金国,钟玲,等.实时三维超声心动图评价右冠状动脉病变患者右心室局部与整体容积及收缩功能变化[J].中华超声影像学杂志,2015,24(10):829-833.
[14]王玉敏,吴晓萍.实时三维超声心动图对慢性心衰病人左室收缩同步性的初步研[J].内蒙古医科大学学报,2015,37(6):547-551,556.
[15]刘丽萍,殷霞,陈建成,等.实时三维超声心动图测量心肌梗死后室壁运动异常患者左室收缩功能的研究[J].山西医药杂志,2018,47(7):772-773.