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目的探讨组织同步化显像技术在评价右束支传导阻滞患者心室同步性与收缩功能中的应用价值。方法24例右束支传导阻滞患者为研究组,25例正常成年人为对照组。应用GE Vivid7彩色超声诊断仪、心肌组织速度显像及分析软件分析两组组织同步化图像,测量心肌收缩速度达峰值时间(T,经心率校正后为TC)及峰值速度(V)。结果①研究组右心室速度曲线具明显特征,其中2/3患者的等容收缩波延迟出现且振幅高于S波;②研究组达峰时间较对照组延长,除后间隔外,余节段的延长均具有统计学意义;③研究组左室达峰时间的标准差(TSD)较对照组大(45.34±18.63)ms对(39.97±11.17)ms,P=0.037,右左心室间达峰时间最大差(TRV-LV)亦较对照组大(118.29±38.25)ms对(91.43±48.54)ms,P=0.04;④研究组除左心室侧壁基底段心肌速度小于对照组(5.06±1.79)cm/s对(6.45±1.57)cm/s,P<0.05外,余节段差异无统计学意义。结论组织同步化显像可以快速、稳定地评价右束支传导阻滞患者的心室同步性和收缩功能,经心率校正后的达峰时间受客观因素影响小,为临床评价心室同步性提供了稳定可靠的指标。
Objective To investigate the value of tissue synchronized imaging in assessing ventricular synchrony and systolic function in patients with right bundle branch block. Methods Twenty-four patients with right bundle branch block were study group and 25 normal adults as control group. The synchronizing images of the two groups were analyzed with GE Vivid7 color sonography, myocardial tissue velocity imaging and analysis software to measure the peak systolic velocity (T, TC after cardio-rhythm correction) and the peak velocity (V). Results ① The right ventricular velocity curve of the study group showed obvious features, of which 2/3 of the patients had delayed onset of isovolumetric contractility wave and the amplitude was higher than that of the S wave. ② The peak time of the study group was longer than that of the control group, except for the posterior interval, (45.34 ± 18.63) ms vs (39.97 ± 11.17) ms, P = 0.037, and the peak time between the right and left interventricular septum in the study group was significantly longer than that in the control group The maximum difference (TRV-LV) was (118.29 ± 38.25) ms vs (91.43 ± 48.54) ms, P = 0.04; ④ The myocardial velocity in the basal segment of left ventricular wall in the study group was less than that in the control group (5.06 ± 1.79) cm / s vs (6.45 ± 1.57) cm / s, P <0.05. There was no significant difference in the remaining segments. Conclusions Tissue synchronization imaging can rapidly and stably evaluate the ventricular systolic and systolic function in patients with right bundle branch block, and the peak time after the correction of heart rate is less affected by objective factors, which provides a stable clinical evaluation of ventricular synchrony Reliable indicator.