中文摘要：

目的：运用实时三维超声心动图（real-time three-dimensional echocardiography，RT．3DE）评估扩张型心肌病（dilated cardiomyopathy，DCM）患者左、右心室收缩功能并探讨其临床应用价值。方法：对50例DCM患者行RT-3DE检查，年龄28-74（39．5＋12．4）岁；50例健康体检者作为正常对照组。采用西门子SC2000心脏超声诊断仪，应用4Zlc三维超声探头行左、右心室成像，用eSieLVA及RVA定量分析软件监测左、右心室收缩功能参数，包括收缩末期容积（ESV）、舒张末期容积（EDV）、每搏心输出量（SV）、射血分数（EF）以及左心室收缩失同步指数即左心室16节段达到最小收缩容积时间的标准差（SDI），并对正常对照组与DCM组各参数进行比较及相关分析。同时从DCM组中选取30例患者进行心脏核磁检查（CMRI），以验证RT-3DE测量方法的可靠性。结果：RT-3DE结果显示DCM组左、右心室收缩功能参数ESV，EDV和SDI明显高于对照组（P〈0．001），EF明显低于对照组（P〈0．001）；DCM组sv与对照组比较，差异无统计学意义（P〉0.05）。DCM组左心室射血分数（LVEF）与SDI呈显著负相关（r=-0．697，P〈0．001），右心室射血分数（RVEF）与LVEF呈正相关（r=0．496，P〈0．01）。30例DCM患者RT-3DE与CMRI检查结果比较，ESV，EDV，EF差异无统计学意义（P〉0．05），且两种测量方法得到的左、右心室EF呈显著正相关（LVEF：r=0．89，P〈0．01；RVEF：r=0．85，P〈0．01）。结论：RT-3DE能通过测量左、右心室收缩功能参数较准确地评价DCM患者心室收缩功能。

英文摘要：

Objective： To assess left and right ventricular systolic function in patients with dilated cardiomyopathy （DCM） using real-time three-dimensional echocardiography （RT-3DE）. Methods： Fifty DCM patients and 50 normal subjects were enrolled. Left and right ventricular systolic function parameters including end-systolic volume （ESV） and end-diastolic volume （EDV）, stroke volume （SV） and ejection fraction （EF） were measured with RT-3DE. The systolicdyssynchrony index （SDI） for left ventricular systolic function was also measured in the same time. The study compared the data of the left and right ventricular systolic functionparameters between the DCM group and the control group. Cardiac magnetic resonance （CMRI） was performed in a subgroup of the 30 DCM patients to confirm RT-3DE measurements. Results： The results ofEDV, ESV and SDI measured by RT-3DE were significantly higher in patient group with DCM than those in the control group （P〈0.001）. The result of EF was significantly lower in patients with DCM than in normal subjects （P〈0.001）, but SV showed no significant difference between the two groups （P〉0.05）. In the DCM group, the results showed a significantly negative correlation between left ventricular ejection fraction （LVEF） and SDI （r=-0.697, P〈0.001）, and there was also a moderate correlation between LVEF and right ventricular ejection fraction （RVEF） （r=0.496, P〈0.01）. The results of ESV, EDV and EF showed no significant differences as measured by RT-3DE or CMRI in the patient group （P〉0.05）, and there was also good correlation between the two measurements （LVEF： r=0.89, P〈0.01; RVEF： r=0.85, P〈0.01）. Conclusion： Left and right ventricular systolic function in DCM could be evaluated by RT-3DE with left and right ventricular systolic function parameters