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

doi:10.13481/j.1671-587x.20170243

吉林大学学报(医学版) ›› 2017, Vol. 43 ›› Issue (02): 429-434.doi: 10.13481/j.1671-587x.20170243

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

王银, 刘悦, 莫钟铃, 陈丽萍

吉林大学第一医院心血管疾病诊治中心心脏彩超室, 吉林长春 130021

收稿日期:2016-10-25 出版日期:2017-03-28 发布日期:2017-03-31
通讯作者: 陈丽萍,副教授,硕士研究生导师(Tel:0431-88783492,E-mail:annie.ch@126.com) E-mail:annie.ch@126.com
作者简介:王银(1988-),男,山东省济宁市人,在读医学硕士,主要从事心血管疾病医学影像诊断学方面的研究。
基金资助:
吉林省科技厅科研基金资助课题（20130413009GH）

Application of three-dimensional speckle tracking echocardiography in evaluation on segmental motion and systolic function of left ventricular in patients with acute myocardial infarction after percutaneous coronary intervention and its values

WANG Yin, LIU Yue, MO Zhongling, CHEN Liping

Department of Echocardioggraphy, First Hospital, Jilin University, Changchun 130021, China

Received:2016-10-25 Online:2017-03-28 Published:2017-03-31

摘要/Abstract

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<0.0001），GRS与LVEF呈正相关关系（r=0.862，P<0.0001）。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。

关键词: 心肌梗死, 三维斑点追踪技术, 经皮冠状动脉介入治疗, 超声心动图

Abstract: 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 three-dimensional 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.

Key words: echocardiography, percutaneous coronary interventrion, myocardial infarction, three-dimensional speckle tracking imaging

中图分类号:

R743

王银, 刘悦, 莫钟铃, 陈丽萍. 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[J]. 吉林大学学报(医学版), 2017, 43(02): 429-434.

WANG Yin, LIU Yue, MO Zhongling, CHEN Liping. Application of three-dimensional speckle tracking echocardiography in evaluation on segmental motion and systolic function of left ventricular in patients with acute myocardial infarction after percutaneous coronary intervention and its values[J]. Journal of Jilin University Medicine Edition, 2017, 43(02): 429-434.

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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

Application of three-dimensional speckle tracking echocardiography in evaluation on segmental motion and systolic function of left ventricular in patients with acute myocardial infarction after percutaneous coronary intervention and its values

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