目的 探讨超声速度向量成像(VVI)技术评价主动脉瓣置换同期施行冠状动脉旁路移植术(CABG)患者手术前、后左心室长轴收缩功能的价值.方法 应用Siemens Sequoia 512超声诊断仪及VVI技术,于术前、术后2周及术后3个月对23例主动脉瓣置换同期接受CABG患者(手术组)行超声心动图检查,并对其左心室16节段心肌长轴方向的收缩期平均峰值速度、应变、应变率进行定量分析；选取20名健康查体者作为对照组.结果 手术组左心室长轴各节段收缩期平均峰值速度、应变和应变率术前组明显低于对照组(P均＜0.01),术后2周左心室长轴基底段及中间段收缩期平均速度、应变和应变率较术前减低(P均＜0.01),术后3个月各节段平均收缩期速度、应变和应变率较术前明显好转(P均＜0.01).左心室射血分数、短轴缩短率组间差异无统计学意义.结论 VVI技术能较常规超声技术更加客观、敏感地评价主动脉瓣置换同期CABG术后患者心功能的变化.%Objective To assess the left ventricular longitudinal systolic function in patients before and after aortic valve replacement (AVR) combined with coronary artery bypass graft (CABG) by using velocity vector imaging (VVI). Methods Siemens Sequoia 512 color Doppler ultrasonic instrument with VVI technique were used to evaluate heart function before, 2 weeks and 3 months after AVR combined with CABG surgery of 23 patients, and 20 normal people were selected as a control group. The left ventricular longitudinal systolic velocity, strain and strain rate of each segment were measured. Results The average left ventricular longitudinal systolic velocity, strain and strain rate of patients before the surgery were significantly lower than those in control group (all P<0. 01). Two weeks after the surgery, the average velocity, strain and strain rate in the basal and middle segment of left ventricle were significantly lower than those before the surgery (all P <0. 01). Three months after the surgery, the average velocity, strain and strain rate were significantly improved than those before the surgery (all P<0. 01). The ejection fractions and fractional shortening were not significantly different between the two groups. Conclusion VVI technique can be used to assess heart function in patients before and after AVR combined with CABG surgery more objectively and sensitively than conventional ultrasonic technique.
展开▼
