速度向量成像评价心尖肥厚性心肌病左室扭转角度和解旋的初步研究

目的 应用速度向量成像(VVI)技术评价心尖肥厚性心肌病(ApHCM)患者左室短轴心肌扭转角度与解旋运动.方法 应用VVI技术对23例ApHCM患者和23例正常人左室短轴心底和心尖水平的心内膜下心肌扭转角度和解旋进行定量分析.结果 与正常组比较,ApHCM组左室短轴心尖部心内膜下心肌收缩期峰值旋转角度、旋转速度以及左室扭转角度均减低(P＜0.05);而两组间心底部心内膜下心肌收缩期峰值旋转角度、旋转速度差异无统计学意义(P＞0.05).ApHCM组舒张早期左室心底部与心尖部心内膜下心肌的峰值解旋速度均低于正常组(P＜0.05).结论 VVI技术可有效评价ApHCM患者左室扭转角度与解旋运动特征,ApHCM患者左室心内膜下心肌的扭转角度与解旋运动均减低.

Abstract：

Objective To evaluate left ventricular(LV) twist and untwist using velocity vector imaging(VVI) in patients with apical hypertrophic cardiomyopathy (ApHCM). Methods Twenty-three patients diagnosed with ApHCM were consecutively enrolled and compared with normal controls. After a standard echocardiographic examination, parasternal basal and apical short-axis planes were scanned to quantify LV rotations,twist and LV untwist using VVI. Results Compared with the normal controls, the rotation and rotaional velocity of apical subendocardial myocardium were markedly decreased in ApHCM patients during the period of systole ( P＜0.05) ,but the decreases in basal planes were not significant. As a consequence,LV twist was significantly lower in ApHCM patients (P＜ 0.05). Compared to normal controls,the velocity of LV untwisting was also significantly decreased in ApHCM patients ( P＜0.05).Conclusions The twist and untwist of LV subendocardial myocardium were decreased in ApHCM patients.VVI is a useful method to assess the characteristics of LV twist and untwist in ApHCM patients.     

基于自制动态心血管3D模型的CBL教学在心脏瓣膜病临床见习中的应用

目的　探讨自制动态心血管3D模型辅助案例导向学习（case-based learning,CBL）教学法在心脏瓣膜病临床见习中的应用效果。方法　选择南京医科大学2016级五年制临床医学专业2个班共60名见习学生作为研究对象,将其平均分为试验组和对照组。试验组接受自制动态心血管3D模型辅助的CBL教学,对照组接受传统教学模型辅助的CBL教学。学习结束后,通过对两组学生进行考核成绩比较和问卷调查评分比较,评价两种教学方法的教学效果。采用SPSS 19.0统计软件进行独立样本t检验和卡方检验。结果　两种教学方法下,试验组学生的基础理论知识和临床思维考试成绩均高于对照组学生[（43.10±3.51）vs.（40.87±3.19）,（42.20±3.15）vs.（40.20±3.81）],差异有统计学意义（P<0.05）。问卷调查结果显示,试验组学生在学习主动性和积极性、理论知识掌握度、临床思维能力、课堂学习兴趣、课堂活跃度及知识讲授清晰度方面的评分均高于对照组学生,差异均有统计学意义（P<0.05）。结论　自制动态心血管3D模型辅助CBL教学法应用在心脏瓣膜病临床见习中,可以培养学生临床诊断思维能力,提高教学质量。     

肺栓塞的彩色多普勒超声心动图诊断研究

目的:探讨彩色多普勒超声心动图在诊断肺栓塞中的价值.方法:回顾分析我院确诊的66例肺栓塞患者的彩色多普勒检查,并与正常组对照.结果:肺栓塞组检出右室扩大64例(97%);右房扩大55例(83%);室间隔运动异常42例(64%);肺动脉扩张29例(44%);右心房血栓5例(7.5%);右心室血栓1例(1.5%);肺动脉血栓6例(9%),肺动脉高压100%.结论:超声心动图是一种有效诊断肺栓塞的方法,早期应用可以提高肺栓塞的诊断水平.