左室壁舒张期运动的不一致性对评判冠心病心肌缺血的价值研究

发布时间：2018-02-21 01:06

本文关键词： 超声心动图冠状动脉粥样硬化性心脏病二尖瓣环运动应变率　出处：《广西医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的：通过研究二尖瓣环运动的不对称性及左室心肌应变率的差异性,探讨其在评判冠状动脉粥样硬化性心脏病(简称冠心病)局部心肌缺血的应用价值。方法：冠心病组31例,其中男性23例,女性8例,平均年龄58.19±9.67岁,行常规心脏超声,未发现室壁运动异常,经冠状动脉造影、CT等检查确诊。正常对照组24例,其中男性14例,女性10例,平均年龄53.46±8.94岁,经过详细询问病史、体检、心电图、超声心动图检查排除心血管及呼吸系统等疾病。所有研究对像行常规超声心动图和应变率成像技术检查,组织多普勒模式分别测量舒张早期、晚期室间隔与左室侧壁二尖瓣环运动速度峰值(e、a)、室间隔与左室侧壁应变率ESR (Early diastolic Strain Rate)、ASR (Late diastolic Strain Rate)参数。计算各组同一个研究对象二尖瓣环室间隔与左室侧壁瓣环运动e峰之间差值(e-dif)、a峰之间的差值(a-dif),室间隔与左室侧壁舒张期ESR之间差值(ESR-dif)、ASR之间的差值(ASR-dif)。计量资料以均数±标准差表示,采用独立样本t检验分析,分别比较两组之间上述指标的差异。结果：1、冠心病患者室间隔及左室侧壁的舒张早期二尖瓣环运动速度e峰、应变率ESR均较正常组降低,并具有统计学差异(P＜0.05),而各个壁的舒张晚期二尖瓣环运动速度a峰、应变率ASR较正常组均无统计学差异。 2、冠心病组e-dif、ESR-dif值与正常对照组比较无统计学差异。而冠心病组a-dif、ASR-dif值与正常对照组比较差异更明显,具有显著统计学意义(P＜0.05)。结论：冠心病左室二尖瓣环运动及室壁心肌应变率存在的不一致性可以有助于评判冠心病局部心肌缺血,为临床早期发现及诊断冠心病提供一种方法。
[Abstract]:Objective: to study the asymmetry of mitral annular movement and the difference of left ventricular myocardial strain rate in order to evaluate the value of mitral annular movement in regional myocardial ischemia of coronary atherosclerotic heart disease (coronary heart disease). Methods: 31 patients with coronary heart disease (CHD), including 23 males and 8 females, with an average age of 58.19 卤9.67 years, underwent conventional echocardiography without abnormal ventricular wall motion, and were confirmed by coronary angiography and CT examination. 10 female patients (mean age 53.46 卤8.94 years) were examined with detailed history, physical examination, electrocardiogram, echocardiography, and other diseases such as cardiovascular and respiratory system. All subjects were examined by conventional echocardiography and strain rate imaging. Tissue Doppler mode was used to measure the early diastolic phase. The peak velocities of mitral annulus in late ventricular septum and left ventricular lateral wall, the strain rate of interventricular septum and left ventricular lateral wall strain rate (ESR) parameters of early diastolic Strain mitral annulus were calculated. The mitral annular septum and left ventricular lateral wall valvular annulus were calculated. The difference between the dynamic e peak and the left ventricular lateral wall diastolic phase, the difference between the ventricular septum and the left ventricular lateral wall diastolic phase (ESR) and the difference between the difference between the dynamic e peak and the e-dif / a peak, and the difference between the ventricular septum and the left ventricular lateral wall diastolic ESR. The measurement data are expressed as the mean 卤standard deviation. The t-test analysis of independent samples was used to compare the differences of the above indexes between the two groups. Results the mitral annular motion velocity e peak and strain rate ESR in early diastolic phase of septum and lateral wall of left ventricle in patients with coronary heart disease were lower than those in normal group (P < 0.05), and the mitral annular movement velocity a peak in late diastolic period of each wall was significantly lower than that in normal group (P < 0.05). There was no significant difference in strain rate ASR compared with normal group. (2) there was no significant difference in the e-diftrol ESR-dif value between the CHD group and the normal control group, but the ASR-dif value in the CHD group was more significant than that in the normal control group (P < 0.05). Conclusion: the inconsistency of left ventricular mitral annular movement and myocardial strain rate in coronary heart disease can be helpful to judge the regional myocardial ischemia of coronary heart disease and provide a method for early detection and diagnosis of coronary heart disease.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R541.4;R445

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