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目的通过检查分析心肌梗死患者和健康对照组左心室不同部位多普勒组织声像图（ＤＴＩ）的不同特征，研究ＤＴＩ评价飞行员左心功能的方法和标准。方法使用Ａｃｕｓｏｎａｓｐｅｎ型彩超仪检查心肌梗死患者３０人，对照组５０人，飞行员２０人。分１３个部位检查左室壁的ＤＴＩ速度模式图，包括二维及Ｍ型彩图和脉冲多普勒频谱图；同步描记心电图（ＥＣＧ）。结果①二维和Ｍ型彩图上朝向探头运动的室壁显示红黄色，背向探头的为蓝绿色；运动速度快时，色彩明亮，反之，色彩阴暗。在梗死区及室壁运动异常部位，色彩缺失、阴暗，或呈相反变化；②频谱图在ＥＣＧＰ波开始后出现房缩波（Ａ），Ｑ波开始后出现等容收缩波（ＩＶＣ）和收缩波（Ｓ），Ｔ波后为等容舒张波（ＩＶＲ）和早期舒张波（Ｅ）。与对照组相比，心肌梗死患者的Ｓ波和Ｅ波显著降低，Ａ波显著增高，Ａ／Ｅ值显著增大；③根据Ｍ型彩图的颜色变化和谱图的波形，可测量室壁不同部位的收缩时间间期和舒张时间间期，为评价局部心肌功能状态提供依据。结论ＤＴＩ的速度模式图对飞行人员的心功能鉴定有重要价值。
Objective To study the methods and criteria of DTI in assessing left cardiac function of pilots by examining different features of Doppler echocardiography (DTI) in different regions of left ventricle of patients with myocardial infarction and healthy controls. Methods Acusonaspen color Doppler was used to examine 30 patients with myocardial infarction, 50 patients in control group and 20 pilots. DTI velocity patterns of the left ventricular wall were examined in 13 sites, including 2D and M-color maps and pulsed Doppler spectra; and simultaneous electrocardiogram (ECG). Results ① On the two-dimensional and M-type color images, the walls moving toward the probe showed red-yellow and blue-green toward the back of the probe; when the speed of movement was fast, the color was bright; on the contrary, the color was dark. In the infarct area and wall motion abnormalities, the color is missing, dark, or the opposite change; ② spectrum in the beginning of ECGP wave after the onset of atrial contraction wave (A), Q wave began to appear after the isovolumic contraction wave (IVC) and contraction Wave (S), T wave after the isovolumic diastolic wave (IVR) and early diastolic wave (E). Compared with the control group, S wave and E wave were significantly decreased in patients with myocardial infarction, A wave was significantly increased, A / E value was significantly increased; ③ According to the M-type color map of the color change and spectral waveform can measure the wall Different parts of the contraction time and diastolic time interval, to assess the functional status of the local myocardium provide the basis. Conclusion The DTI velocity pattern is of great value to the identification of pilots’ cardiac function.