心肌分层应变评价冠心病患者不同程度狭窄冠状动脉供血节段心肌收缩功能

发布时间：2018-10-15 10:12

【摘要】：目的采用二维斑点追踪成像(2D-STI)分层应变技术评价冠心病患者左心室局部收缩功能。方法临床疑诊冠心病患者50例,根据SCA结果,将患者分为冠心病组(重度狭窄亚组和轻度狭窄亚组)和对照组。获取各组节段心内膜下、中层、心外膜下心肌纵向应变(LSendo、LSmid、LSepi)及心肌圆周应变(CSendo、CSmid、CSepi),计算各节段心肌纵向应变跨壁梯度△LS和各节段心肌圆周应变跨壁梯度△CS,并进行统计学分析。结果无论有无冠状动脉狭窄,其相应供血左心室心肌节段LSendo、LSmid、LSepi和CSendo、CSmid、CSepi均呈梯度递减,3组间△LS差异无统计学意义,重度狭窄亚组及轻度狭窄亚组△CS较对照组显著减小(P0.05);与对照组比较,重度狭窄亚组LSendo、LSmid、LSepi及轻度狭窄亚组LSmid、LSepi均显著减低(P0.05),但轻度狭窄亚组与重度狭窄亚组间各纵向分层应变参数差异无统计学意义(P均0.05);与对照组比较,重度狭窄亚组CSendo、CSmid、CSepi均显著降低(P均0.05),轻度狭窄组CSendo显著降低(P0.05);重度狭窄亚组与轻度狭窄亚组间各圆周分层应变差异无统计学意义(P均0.05)。结论 2D-STI心肌分层应变技术可准确评价冠心病患者左心室各层心肌纵向及圆周应变,冠心病患者重度狭窄冠状动脉供血节段心肌全层收缩功能均不同程度受损,其中以心内膜下心肌受损最为严重。
[Abstract]:Objective to evaluate the left ventricular regional systolic function in patients with coronary heart disease by using two-dimensional speckle tracing imaging (2D-STI) stratified strain technique. Methods 50 patients with suspected coronary heart disease were divided into coronary heart disease group (severe stenosis subgroup and mild stenosis subgroup) and control group according to SCA results. The longitudinal strain (LSendo,LSmid,LSepi) and myocardial circumferential strain (CSendo,CSmid,CSepi) of subendocardial, middle and epicardial myocardium were obtained in each group. The transmural gradient LS of myocardial longitudinal strain and the transmural gradient CS, of each segment of myocardium were calculated and analyzed statistically. Results with or without coronary artery stenosis, the LSendo,LSmid,LSepi and CSendo,CSmid,CSepi of the corresponding left ventricular segments decreased gradually, and there was no significant difference in LS among the three groups. The CS of severe stenosis subgroup and mild stenosis subgroup was significantly lower than that of control group (P0.05). LSendo,LSmid,LSepi and LSmid,LSepi were significantly decreased in severe stenosis subgroup and mild stenosis subgroup (P0.05), but there was no significant difference in longitudinal stratification strain parameters between mild stenosis subgroup and severe stenosis subgroup (P 0.05). CSendo,CSmid,CSepi in severe stenosis subgroup was significantly lower than that in mild stenosis group (P0.05), and there was no significant difference between severe stenosis subgroup and mild stenosis subgroup (P 0.05). Conclusion 2D-STI can accurately evaluate the longitudinal and circumferential strain of left ventricular myocardium in patients with coronary heart disease, and the whole myocardial systolic function of coronary artery stenosis in patients with severe coronary artery stenosis is impaired in varying degrees. The subendocardial myocardial damage was the most serious.
【作者单位】：武汉大学人民医院超声科;
【基金】：湖北省卫计委青年人才项目(WJ2015Q016)
【分类号】：R541.4;R445.1

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