斑点追踪成像技术结合三维超声评价缺血性二尖瓣反流患者的乳头肌功能

发布时间：2018-02-07 10:05

本文关键词： 心肌缺血二尖瓣闭锁不全超声心动描记术三维斑点追踪成像心室功能左乳头肌　出处：《中国医学影像学杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的应用斑点追踪成像(STI)及三维超声评价缺血性二尖瓣反流患者乳头肌的功能,并探讨缺血性二尖瓣反流(IMR)的影响因素,为临床预测IMR提供依据。资料与方法收集合并二尖瓣反流的缺血性心肌病患者76例为病例组,同时选取66例健康志愿者为正常对照组。两组受检者均行超声心动图及2D-STI检查,分别比较前后乳头肌的缩短率(AFS、PFS)、前后乳头肌(APM、PPM)到二尖瓣前瓣环的距离(APM-AMA、PPM-AMA)、二尖瓣瓣叶闭合面积(MLC)、乳头肌间距离(IPMD)、前后乳头肌相对于左心室前壁的角度变化(Ang I、Ang II)、前后乳头肌的纵向峰值应变(ALS、PLS)、纵向应变达峰时间(APT、PPT)及达峰延迟时间(DT)以及左心室舒张末期内径(LVIDD)、左心室舒张末期容积(LVEDV)、左心室射血分数(LVEF)。结果病例组与正常对照组LVIDD、LVEDV、LVEF相比,差异有统计学意义(P0.05),两组AFS、PFS、IPMD、MLC、ALS、PLS及DT相比,差异有统计学意义(P0.05)。ALS、PLS、AFS、PFS与LVEF呈正相关,与LVEDV呈负相关(P0.05);MLC、IPMD、DT与LVEF呈负相关(P0.05)。冠状动脉Gensini积分与ALS、PLS、MLC、AFS、PFS、IPMD有相关性,r值分别为-0.65、-0.78、0.54、-0.51、-0.57、0.49。经多元Logistic回归分析发现IPMD、MLC、PLS、DT与IMR有关联(P0.05),OR值分别为1.26、1.32、1.37、1.52。结论应用2D-STI技术能够准确评价心肌缺血导致的乳头肌功能障碍,并且IPMD及MLC增加、PLS减低、两组乳头肌运动不同步均为IMR的危险因素,该结果有助于临床预测IMR。
[Abstract]:Objective to evaluate the function of papillary muscle in patients with ischemic mitral regurgitation by dot tracing imaging (STI) and three-dimensional ultrasound, and to explore the influencing factors of ischemic mitral regurgitation (IMR). Methods 76 patients with ischemic cardiomyopathy complicated with mitral regurgitation were selected as the case group and 66 healthy volunteers as the control group. Echocardiography and 2D-STI were performed in both groups. The shortening rate of the anterior and posterior papillary muscles and the distance between the anterior and posterior papillary muscles and the anterior mitral annulus were compared. The APM-AMA-PPM-AMAA, the closed area of the mitral lobe and the distance between the papillary muscles and the anterior wall of the left ventricle were compared respectively. The angle of the anterior and posterior papillary muscles relative to the anterior wall of the left ventricle was changed. The longitudinal peak strain of posterior papillary muscle (ALS PPTT) and peak delay time (DTT), left ventricular end-diastolic dimension (LVIDD), left ventricular end-diastolic volume (LVEDVV), left ventricular ejection fraction (LVVEFV), left ventricular ejection fraction (LVEFV) were compared between the case group and the normal control group (P < 0.05), and the left ventricular end-diastolic dimension (LVIDD), left ventricular end-diastolic volume (LVEDVV) and left ventricular ejection fraction (LVEFV) were compared between the case group and the control group. The difference was statistically significant (P 0.05). There was a positive correlation between LVEF and LVEF in the two groups. There was a negative correlation between Gensini and LVEDV. The correlation between Gensini score of coronary artery and LVEF was -0.65- 0.78-0.54 ~ 0.570.49.The results of multivariate Logistic regression analysis showed that there was a significant correlation between Gensini and IMR (P 0.05OR = 1.26 卤1.32n 1.371.52.Conclusion 2D-STI technique can be used to accurately evaluate the myocardial function of the patients with Gensini and IMR, respectively. Conclusion 2D-STI technique can be used to accurately evaluate the myocardial function of the patients with P0.05M, P < 0.05, P < 0.05). Conclusion 2D-STI can be used to accurately evaluate the myocardial function of the patients with IMR. Conclusion\\\%\%\%\%\%\%\%\% Logistic\%\%\%\%. Ischemia-induced papillary dysfunction, In addition, IPMD and MLC increased and decreased, and the abnormal movement of papillary muscles in both groups was the risk factor of IMR. The results were helpful for clinical prediction of IMR.
【作者单位】：河北承德医学院研究生学院;保定市第一中心医院超声科;
【分类号】：R542.5

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