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目的应用实时三维超声技术对左心室心肌致密化不全(LVNC)患者左心房管道功能和助力泵功能进行研究,并探讨其在LVNC诊断的价值。方法选择有典型LVNC超声表现的患者(LVNC组)20例,其中男性7例,女性13例,年龄4~55岁,平均年龄32.8岁。4~16岁3例,17~35岁9例,36~55岁8例。以20例年龄相匹配的健康人作为正常对照组。应用Philips iE33彩色多普勒超声诊断仪,采集二维左心测量值及三维左心心尖四腔切面full-volume图像,应用Qlab软件进行脱机分析。结果二维测量得出LVNC组与正常对照组在室间隔厚度、左心室舒张末内径及左心室收缩功能差异均无统计学意义(P>0.05)。管道功能:LVNC组左心房被动排空容积/体表面积(BSA)、左心房管道容积/BSA及左心房被动排空指数差异无统计学意义(P>0.05),表明LVNC组与正常对照组左心房管道功能无明显差异。助力泵功能:LVNC组左心房主动排空容积/BSA为(8.73±3.92)mL/m~2,明显高于正常对照组[(5.53±2.93)mL/m~2](P<0.01);LVNC组左心房主动排空指数为(51.27±9.68)%,明显高于对照组[(36.25±12.47)%](P<0.01)。结论 LVNC患者左心房助力泵功能增加,间接反映LVNC患者左心室舒张功能减低。应用实时三维超声技术可以对LVNC患者心脏功能进行评估。
Objective To study the function of left atrium and the function of booster pump in patients with left ventricular myocardial degeneration (LVNC) by real-time three-dimensional ultrasound and to explore its value in the diagnosis of LVNC. Methods Twenty patients (LVNC group) with typical LVNC ultrasonography were selected. There were 7 males and 13 females, aged 4 to 55 years with a mean age of 32.8 years. 4 to 16 years in 3 cases, 17 to 35 years in 9 cases, 36 to 55 years in 8 cases. Twenty healthy subjects with the same age as the normal control group. The Philips iE33 color Doppler ultrasound system was used to acquire two-dimensional left heart measurements and full-volume three-dimensional left-apex four-chamber full-volume images. The Qlab software was used for offline analysis. Results Two-dimensional measurement showed that LVNC group and normal control group had no significant difference in the thickness of interventricular septum, left ventricular end-diastolic diameter and left ventricular systolic function (P> 0.05). Piping function: There was no significant difference in passive left ventricular volume / body surface area (BSA), left ventricular volume / BSA and left ventricular passive emptying index in LVNC group (P> 0.05) Atrial and duct function no significant difference. The volume of the left atrium and the volume of BSA in LVNC group were (8.73 ± 3.92) mL / m ~ 2, significantly higher than those in the control group [(5.53 ± 2.93) mL / m ~ 2] The left ventricular active expulsion index in LVNC group was (51.27 ± 9.68)%, which was significantly higher than that in control group (36.25 ± 12.47%) (P <0.01). Conclusion LVNC patients with left atrium boost pump function increased, indirectly reflecting LVNC patients with decreased left ventricular diastolic function. Real-time three-dimensional ultrasound can be used to assess cardiac function in LVNC patients.