三维斑点追踪技术在评价急性心肌梗死经皮冠状动脉治疗术后近期左室壁运动和收缩功能中的应用及其价值

发布时间：2018-06-03 10:45

本文选题：心肌梗死 + 超声心动图　；参考：《吉林大学学报(医学版)》2017年02期

【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(P0.05);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,P0.000 1),GRS与LVEF呈正相关关系(r=0.862,P0.000 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。
[Abstract]:Objective: To evaluate the strain, the overall left ventricular strain and the left ventricular systolic function after percutaneous coronary intervention (PCI) in the elderly patients with acute myocardial infarction (3D-STI), and to elucidate the characteristics and clinical value of early myocardial strain modification after PCI. Methods: to select the left anterior descending branch. 30 patients with PCI were treated as case group, and 30 healthy middle-aged and elderly people were selected as control group. After routine acquisition of two-dimensional ultrasound data, 3D-STI was used to detect myocardial motion and contractile function in 2 groups of subjects. The left ventricular segments and overall longitudinal strain (GLS), radial strain (GRS), circumferential strain (GCS) and area strain (GA) were collected. S) value and left ventricular ejection fraction (LVEF) value. Results: compared with the control group, the total strain values of the patients in the case group were lower than those of the control group. In the strain values of each segment, the longitudinal strain (LS) of the left ventricular segment of the left ventricle in the case group was reduced, the value of the circumferential strain (CS) of the 8/16 segment decreased, the radial strain (RS) of the 5/16 segment decreased, and the 11/16 segment surface was reduced. The value of accumulated strain (AS) was reduced (P0.05), and the segment of strain decreased mainly in the basal segment of the anterior wall, the middle of the anterior wall, the anterior apical segment, the anterior septum basal segment, the middle segment of the anterior septum, the posterior septum basal segment, the posterior septum, the posterior septum apex segment. The case group was negatively correlated with the GLS, GAS and GCS (r=-0.819, r=-0.897, r=-0.807, P0.000 1), GRS. There is a positive correlation with LVEF (r=0.862, P0.000 1). Conclusion: 3D-STI can be used to quantitatively analyze the changes of myocardial strain and cardiac function in early left ventricular myocardium of AMI patients, which can be used as an objective index for evaluating the curative effect of PCI after operation.
【作者单位】：吉林大学第一医院心血管疾病诊治中心心脏彩超室;
【基金】：吉林省科技厅科研基金资助课题(20130413009GH)
【分类号】：R542.22;R540.45

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