经胸三维彩色多普勒超声心动图定量评价左心室搏出量的临床研究

摘要

Objective To assess the accuracy of three-dimensional color Doppler echocardiography (3DCDE) for measuring left ventricular stroke volume (LVSV). Methods A total of 45 patients were studied to measure LVSV by 3DCDE and two-dimensional Doppler echocardiograph(2DDE). Full-volume three-dimensional echocardiography (3DE) was also performed to measure left ventricular end systolic (LVESV) ,end diastolic(LVEDV) ,and LVSV (LVEDV-LVESV), which served as a reference standard for comparison. Results Mean values of LVSV by 3DE,2DDE,3DCDE were (79. 3 ± 22. 6)ml, (74. 0 ± 20. 6) ml,(78. 7 ±22. 6)ml. respectively. Compared with LVSV by 3DE,the correlation was excellent for 3DCDE (r = 0.96), good for 2DDE ( r =0.89). Conclusions LVSV measurement by 3DCDE is reasonably accurate. This new technology may be a valuable clinical tool for assessing cardiac function.%目的 评价经胸三维彩色多普勒超声心动图(3DCDE)测量左心室搏出量(LVSV)的准确性.方法 45例门诊患者,其中心内结构正常者15例,冠心病患者15例,扩张型心肌病患者15例.分别应用二维多普勒超声心动图(2DDE)、3DCDE和全容积三维超声心动图(3DE)测量LVSV.以3DE测量LVSV作为参考值,3DCDE及2DDE测量LVSV分别与之比较分析.结果 三种方法测算的LVSV平均值分别为:3DE(79.3±22.6)ml,2DDE(74.0±20.6)ml,3DCDE(78.7±22.6)ml.3DCDE测值与3DE测值比较差异无统计学意义(P=0.06);2DDE测量的LVSV较3DE测值显著低估(P<0.001).相关性分析显示,3DCDE和2DDE测值与3DE测值均具有良好的相关性(r:0.96和r:0.89),而3DCDE测值较2DDE测值具有更好的相关性.结论 应用经胸3DCDE技术测量左室流出道血流量可以准确方便地测量LVSV,较2DDE方法准确性更高,可能成为临床评价心功能有价值的工具.