组织多普勒测量Tei指数评价冠心病患者左室整体功能,本论文可用于多普勒论文范文参考下载，多普勒相关论文写作参考研究。
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【摘 要】 目的 探討组织多普勒成像（TDI）测量Tei指数评价冠状动脉粥样硬化性心脏病（冠心病）患者左室功能的临床价值.方法 选取90例临床确诊的冠心病患者作为冠心病组, 根据左室射血分数（LVEF）分为A组（LVEF正常者, 即LVEF≥50%）和B组（LVEF减低者, 即LVEF<50%）,各45例.另选同期60例体格检查健康者作为对照组, 并根据年龄分为C1组（年龄<45岁）和C2组（年龄≥45岁）, 各30例.行常规超声心动图检查测量舒张晚期血流峰值和二尖瓣口舒张早期之比（A/E）、E峰减速时间（DT）、左室等容舒张时间（LIVRT）, 记录二尖瓣环的PW-TDI频谱图, 测量相关时间间期, 计算出Tei指数.结果 ①C2组A峰升高, E峰降低, A/E>1, C2组A/E为（1.30±0.83）, C1组为（0.77±0.21）, 比较差异有统计学意义（P<0.01）, 两组LVEF、DT、LIVRT比较差异无统计学意义（P>0.05）.②B组LVEF为（0.37±0.04）明显低于A组（0.60±0.05）和C2组（0.61±0.08）（P<0.01）, A组与C2组LVEF、A/E、DT比较差异无统计学意义（P>0.05）.③B组DT最小, A组和B组LIVRT均较C2组延长, 差异有统计学意义（P<0.01）.④C2组TDI-Tei指数高于C1组, 但差异无统计学意义（P>0.05）.⑤和C2组比较, A组和B组的ICT+IRT逐渐延长, ET逐渐缩短, 差异有统计学意义（P<0.01）.⑥A组和B组TDI-Tei指数均高于C2组, 且B组增高幅度大于A组, 差异有统计学意义（P<0.01）.结论 ①正常人随着年龄增长（尤其是45岁以上者）左室舒张功能减低, 但左室的整体功能不受年龄影响, 随年龄增长并无明显减低.②收缩功能正常及收缩功能减低冠心病患者的左室整体功能均较正常人减低, 且收缩功能减低的冠心病患者的左室整体功能减低更明显.③TDI-Tei指数能综合评价冠心病患者左室的整体收缩和舒张功能, 较常规评价心功能的指标更简便、准确、敏感.
【关键词】 组织多普勒成像Tei指数；左室收缩功能；舒张功能；冠状动脉粥样硬化性心脏病
DOI：10.14163/j.cnki.11-5547/r.2018.08.002
Evaluation of overall left ventricular function in patients with coronary heart disease by tissue Doppler measurement of Tei index CHANG Jing. Second Affiliated Hospital of Shenyang Medical College, Shenyang 110005, China
【Abstract】 Objective To discuss the clinical value of tissue Doppler imaging （TDI） for measurement of Tei index in evaluation of overall left ventricular function in patients with coronary heart disease. Methods A total of 90 patients with clinically confirmed coronary heart disease as coronary heart disease group, and they were divided by left ventricular ejection fraction （LVEF） into group A （normal LVEF, LVEF≥50%） and group B （reduced LVEF, LVEF < 50%）, with 45 cases in each group. Concurrent 60 healthy subjects were taken as control group, and they were divided by age into group C1 （age < 45 years old） and group C2 （age≥45 years old）, with 30 cases in each group. Routine echocardiography was performed to measure the ratio of late diastolic peak flow velocity/early diastolic peak flow velocity （A/E）, E peak decelerating time （DT） and left ventricular isovolumic relaxation time （LIIVRT）. The PW-TDI spectrum of the mitral annulus was recorded, and the related time interval was measured to evaluate the Tei index. Results ①Group C2 had A peak increased, and E peak decreased. A/E>1, group C2 had A/E as （1.30±0.83）, which was （0.77±0.21） in group C1, and their difference was statistically significant （P<0.01）. Both groups had no statistically significant difference in LVEF, DT and LIVRT （P>0.05）.②Group B had obviously lower LVEF as （0.37±0.04） than （0.60±0.05）in group A and （0.61±0.08） in group C2, and the difference was statistically significant （P<0.01）. Group A and group C2 had no statistically significant difference in LVEF, A/E and DT （P>0.05）. ③Group B has smallest DT, and group A had group B had prolonged LIVRT than group C2, and the difference was statistically significant （P<0.01）. ④Group C2 had higher TDI-Tei index than group C1, but the difference was not statistically significant （P>0.05）. ⑤Compared with group C2, group A and group B had gradually extended ICT+IRT, and gradually shortened ET, and the difference was statistically significant （P<0.01）. ⑥Group A and group B had higher TDI-Tei index than group C2, and group B had greater increased range than group A, and the difference was statistically significant （P<0.01）. Conclusion ①The left ventricular diastolic function is decreased in normal persons （especially those over 45 years old）, but the overall left ventricular function is not affected by age, and has no significant decrease with age. ②The overall left ventricular function in coronary heart disease patients with normal and decreases systolic function is lower than that of normal persons, and the reduction of overall left ventricular function in coronary heart disease patients with reduced systolic function is more obvious. ③The TDI-Tei index can evaluate the overall systolic and diastolic function of the left ventricular in patients with coronary heart disease. It is more convenient, accurate and sensitive than the routine evaluation of cardiac function.
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