2020 年第 3 期 第 15 卷

二维超声心动图评价主动脉瓣反流患者左心室构型改变的价值探讨

Two-dimensional echocardiography in evaluation of left ventricular geometric changes in patients with aortic regurgitation

作者：矫妮朱芳丁明岩赵含章栾波

英文作者：

单位：辽宁省人民医院心功能科，沈阳110016

英文单位：

关键词：主动脉瓣反流；二维超声心动图；左心室构型

英文关键词：

• 摘要：

• 【摘要】目的    探讨二维超声心动图评价主动脉瓣反流患者左心室构型改变的价值。方法    选取2018年1—12月就诊于辽宁省人民医院的轻、中、重度主动脉瓣反流患者各20例分别作为轻度组、中度组和重度组，选取同期健康体检者20例作为对照组。所有研究对象均给予二维超声心动图检查，比较二维超声心动图测量参数，包括舒张末期、收缩末期左心室长径（Ld、Ls），与左心室长径垂直并将其三等分的3条横径（D1、D2、D3），舒张末期、收缩末期球形指数（SId、SIs），（D1＋D2＋D3）/3Ld和（D1＋D2＋D3）/3Ls，舒张期、收缩期左心室侧壁间隔横径（LSd、LSs）以及与横径垂直的左心室前后径（APd、APs）。结果    左心室长轴构型参数方面，轻度组与对照组差异均无统计学意义（均P＞0.05）；中度组D1、D2、D3、Ld、Ls、SIs、（D1＋D2＋D3）/3Ld明显高于对照组和轻度组，SId和（D1＋D2＋D3）/3Ls明显低于对照组和轻度组（均P＜0.05）；重度组D1、D2、D3、Ld、Ls、SIs、（D1＋D2＋D3）/3Ld明显高于中度组［（5.40±0.68）cm比（3.98±0.56）cm、（6.30±0.70）cm比（4.80±0.64）cm、（6.62±0.80）cm比（5.12±0.66）cm、（9.8±1.4）cm比（7.8±1.0）cm、（8.3±1.4）cm比（7.7±0.5）cm、（1.83±0.13）比（1.64±0.15）、（0.74±0.08）比（0.73±0.07）］，SId和（D1＋D2＋D3）/3Ls明显低于中度组［（1.25±0.16）比（1.29±0.18）、（0.51±0.02）比（0.58±0.03）］（均P＜0.05）。左心室短轴构型参数方面，轻度组与对照组差异均无统计学意义（均P＞0.05）；中度组LSd、LSs、APd、APs明显高于对照组和轻度组，LSs/APs明显低于对照组和轻度组（均P＜0.05）；重度组LSd、LSs、APd、APs明显高于中度组［（6.3±1.0）cm比（4.8±0.9）cm、（4.6±0.8）cm比（3.2±0.9）cm、（7.4±1.2）cm比（5.5±0.7）cm、（5.8±1.0）cm比（3.8±0.8）cm］（均P＜0.05），LSs/APs与中度组比较差异无统计学意义（P＞0.05）；4组LSd/APd差异均无统计学意义（均P＞0.05）。结论    二维超声心动图能够很好地对中重度主动脉瓣反流患者的左心室构型改变情况进行评价。

  
  

• 【Abstract】Objective    To investigate the value of two-dimensional echocardiography in evaluating left ventricular geometric changes in patients with aortic regurgitation. Methods    From January to December 2018, 20 patients with mild aortic regurgitation（mild group）, 20 patients with moderate aortic regurgitation（moderate group）, 20 patients with severe aortic regurgitation（severe group） and 20 healthy people（control group） were enrolled at Liaoning Provincial People′s Hospital. All subjects were performed two-dimensional echocardiography. Echocardiographic parameters including end-diastolic and end-systolic left ventricular long diameter（Ld and Ls）, left ventricular transverse diameter perpendicular to long diameter and trisecting long diameter（D1, D2, D3）, end-diastolic and end-systolic spherical index（SId and SIs）, （D1＋D2＋D3）/3Ld and （D1＋D2＋D3）/3Ls, diastolic and systolic left ventricular lateral septal transverse diameter（LSd and LSs）, diastolic and systolic left ventricular anteroposterior diameter（APd and APs） were analyzed. Results    There were no statistical differences in left ventricular long axis geometric parameters between mild group and control group（all P＞0.05）. In moderate group there were significantly higher D1, D2, D3, Ld, Ls, SIs, (D1＋D2＋D3)/3Ld and lower SId and （D1＋D2＋D3）/3Ls as compared with control group and mild group（all P＜0.05）. In severe group there were significantly higher D1, D2, D3, Ld, Ls, SIs, (D1＋D2＋D3)/3Ld and lower SId and （D1＋D2＋D3）/3Ls as compared with moderate group［（5.40±0.68）cm vs （3.98±0.56）cm， （6.30±0.70）cm vs （4.80±0.64）cm， （6.62±0.80）cm vs （5.12±0.66）cm， （9.8±1.4）cm vs （7.8±1.0）cm， （8.3±1.4）cm vs （7.7±0.5）cm， （1.83±0.13） vs （1.64±0.15）， （0.74±0.08） vs （0.73±0.07）， （1.25±0.16） vs （1.29±0.18）， （0.51±0.02） vs （0.58±0.03）］（all P＜0.05）. There were no significant differences in left ventricular short axis geometric parameters between mild group and control group（all P＞0.05）. In moderate group there were significantly higher LSd, LSs, APd, APs and lower LSs/APs as compared with control group and mild group（all P＜0.05）. In severe group there were significantly higher LSd, LSs, APd and APs as compared with moderate group［（6.3±1.0）cm vs （4.8±0.9）cm， （4.6±0.8）cm vs （3.2±0.9）cm， （7.4±1.2）cm vs （5.5±0.7）cm， （5.8±1.0）cm vs （3.8±0.8）cm］（all P＜0.05） but no increase in LSs/APs（P＞0.05）. There was no significant difference in LSd/APd among the 4 groups（P＞0.05）. Conclusion    Two-dimensional echocardiography can be used to evaluate left ventricular geometric changes in patients with moderate to severe aortic regurgitation.