摘要
目的:利用实时三维斑点追踪技术(3D-STI)评价中老年急性心肌梗死患者经皮冠状动脉介入治疗术(PCI)后心肌各节段应变、左室整体应变及左心室整体收缩功能,阐明其PCI术后早期心肌应变改变特点及其临床价值。方法:选取因左前降支病变行PCI术患者30例作为病例组,同期选取健康中老年人30名作为对照组,常规获取二维超声资料后,运用3D-STI对2组受试者进行心肌运动及收缩功能检测,收集左心室各节段及整体纵向应变(GLS)、径向应变(GRS)、圆周应变(GCS)和面积应变(GAS)值以及左室射血分数(LVEF)值。结果:与对照组比较,病例组患者整体应变值低于对照组对应节段,各节段应变值中,病例组左心室9/16节段的纵向应变(LS)值减低,8/16节段的圆周应变(CS)值减低,5/16节段的径向应变(RS)值减低,11/16节段的面积应变(AS)值减低(P<0.05);应变值减低节段主要集中于前壁基底段、前壁中间段、前壁心尖段、前间隔基底段、前间隔中间段、后间隔基底段、后间隔中间段、后间隔心尖段。病例组GLS、GAS和GCS与LVEF呈负相关关系(r=-0.819,r=-0.897,r=-0.807,P<0.000 1),GRS与LVEF呈正相关关系(r=0.862,P<0.000 1)。结论:3D-STI能够定量分析AMI患者PCI术后早期左心室心肌应变及心功能的变化,可作为PCI术后疗效评估的客观指标。
Objective：To evaluate the left ventricular segmental strains,global strains and systolic function in the patients with acute myocardial infarction（AMI）after percutaneous coronary intervention（PCI）with threedimensional speckle tracking echocardiography（3D-STI）,and to clarify the characteristics of early myocardial strain changes after PCI and their clinical values.Methods：Thirty patients received PCI for left anterior descending branch disease were enrolled as case group;at the same period,30 healthy middleaged and elderly people were selected as control group.After two-dimensional ultrasound data were obtained regularly,the myocardial motion and systolic functions of the patients in two groups were detected with 3D-STI,and all segmental strain,global longitudinal strain（GLS）,global radial strain（GRS）,global circumferential strain（GCS）and global area strain（GAS） values of left ventricle and left ventricular ejection fraction（LVEF） values were collected.Results：Compared with control group,the global strain values of the patients in case group were lower than those in control group;9/16 longitudimal strain（LS）,8/16 circumferential strain（CS）,5/16 radial strain（RS）and 11/16 area strain（AS）were significantly lower than those in control group（P〈0.05）.The decrease of strain value was mainly concentrated in the anterior segment of the anterior wall,the anterior segment of the anterior wall,anterior apical segment,anterior septal basal segment,anterior septal segment,posterior septal basal segment,posterior septal segment,and posterior septal segment.The GLS,GAS and GCS in case group were negatively correlated with LVEF（r=-0.819,r=-0.897,r=-0.807,P〈0.0001）;the GRS was postively correlated with LVEF（r=0.862,P〈0.0001）.Conclusion：3D-STI can quantitatively analyze the segmental wall motion of left ventricle and could apply the parameters to evaluate the therapeutic efficacy after PCI.
作者
王银
刘悦
莫钟铃
陈丽萍
WANG Yin LIU Yue MO Zhongling CHEN Liping(Department of Echocardioggraphy, First Hospital, Jilin University, Changchun 130021, China)
出处
《吉林大学学报（医学版）》
CAS
CSCD
北大核心
2017年第2期429-434,共6页
Journal of Jilin University：Medicine Edition
基金
吉林省科技厅科研基金资助课题(20130413009GH)
关键词
心肌梗死
超声心动图
三维斑点追踪技术
经皮冠状动脉介入治疗
myocardial infarction
echocardiography
three-dimensional speckle tracking imaging
percutaneous coronary interventrion
