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目的采用二维斑点追踪技术(STE)评价不同亚型的CLBBB患者左心室功能及同步性。方法选择CLBBB患者80例,根据T波方向在I、V5或V6导联与QRS主波方向是否相同,将其分为同向型(cLBBB)组和异向型(dLBBB)组。健康者40例作为对照组。采用STE检测左心室心肌整体纵向峰值应变(LS-G)和左心室18节段心肌纵向应变达峰时间的标准差(SDt)。结果 (1)cLBBB组及dLBBB组SDt均大于对照组(P<0.01);且dLBBB组SDt大于cLBBB组(P<0.05)。(2)cLBBB组及dLBBB组LS-G及LVEF显著小于对照组(P<0.01);且dLBBB组小于cLBBB组。(3)与对照组比较,cLBBB组及dLBBB组E/A及EDT减小,E/e′增大(P<0.05),而后两组无显著差异。结论 CLBBB患者左心室功能及收缩同步性减低,且异向型CLBBB患者减低更显著。
Objective To evaluate left ventricular function and synchrony in patients with different subtypes of CLBBB by two-dimensional speckle tracking (STE). Methods Eighty patients with CLBBB were selected and divided into two groups: cLBBB group and dLBBB group according to whether the direction of I wave, V5 or V6 lead and QRS wave were the same. 40 healthy people as a control group. The standard deviation (SDt) of left ventricular total longitudinal peak strain (LS-G) and peak vertical strain of 18 segments of left ventricular myocardium was determined by STE. Results (1) The SDt of cLBBB group and dLBBB group were higher than that of control group (P <0.01). SDT of dLBBB group was higher than that of cLBBB group (P <0.05). (2) LS-G and LVEF in cLBBB group and dLBBB group were significantly lower than those in control group (P <0.01); and dLBBB group was smaller than cLBBB group. (3) Compared with control group, E / A and EDT decreased and E / e increased (P <0.05) in cLBBB group and dLBBB group, but there was no significant difference between the two groups. Conclusions The left ventricular function and systolic synchrony in patients with CLBBB are decreased, and the reduction in patients with CLBBB is more significant.