实时三维超声心动图评价冠心病患者经皮冠状动脉介入治疗后左心室收缩同步性及功能  

Assessment of left ventricular systolic synchrony and systolic function by real-time three-dimensional echocardiography in patients with coronary artery disease after percutaneous coronary intervention

作　　者：叶振盛[1] 欧宓[1] 陈斌[2] 郭薇[2] 

机构地区：[1]福建省立医院超声心动图室,福州350001 [2]福建省心血管病研究所

出　　处：《中华医学超声杂志（电子版）》2011年第10期2126-2134,共9页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的应用实时三维超声心动图(RT-3DE)评价冠心病患者PCI治疗前后左心室收缩同步性及收缩功能。方法采用超声诊断仪对20例经冠状动脉造影检查证实均有左前降支冠状动脉梗阻的冠心病患者(冠心病组)分别于PCI治疗前、治疗后1周及健康志愿者20名(健康对照组)进行RT-3DE检查。在Qlab6.0定量分析软件上脱机分析所采集的全容积图像,通过测量分析左心室节段-容积曲线,获取左心室收缩功能参数:左心室节段射血分数(rLVEF);记录左心室收缩同步性参数:Tmsv-16-sd、Tmsv-12-sd、Tmsv-16-dif、Tmsv-12-dif、Tmsv-16-sd%、Tmsv-12-sd%、Tmsv-16-dif%、Tmsv-12-dif%。采用SPSS13.0统计软件进行分析,冠心病组PCI治疗前、治疗后参数比较采用配对t检验,冠心病组与健康对照组参数比较采用独立样本t检验。结果冠心病组PCI治疗前左心室收缩同步性参数Tmsv-16-sd、Tmsv-12-sd、Tmsv-16-dif、Tmsv-12-dif、Tmsv-16-sd%、Tmsv-12-sd%、Tmsv-16-dif%、Tmsv-12-dif%测值分别为:(149.2±15.7)ms、(77.5±63.0)ms、(308.0±198.8)ms、(227.2±193.8)ms、(10.9±6.3)%、(8.4±6.7)%、(32.9±21.9)%和(24.1±22.1)%,均大于健康对照组的测值:(23.8±20.7)ms、(15.6±21.3)ms、(81.9±73.1ms)、(65.6±90.3)ms、(2.6±2.4)%、(1.7±1.9)%、(11.2±11.7)%和(6.9±8.6)%,差异有统计学意义(t=-3.714～-6.588,P均<0.05)。冠心病组PCI治疗后左心室收缩同步性参数Tmsv-16-sd、Tmsv-12-sd、Tmsv-16-dif、Tmsv-12-dif、Tmsv-16-sd%、Tmsv-16-dif%测值分别为:(58.8±50.1)ms、(43.7±54.6)ms、(192.8±160.8)ms、(126.9±162.7)ms、(7.0±6.4)%和(21.7±19.9)%,较PCI治疗前(149.2±15.7)ms、(77.5±63.0)ms、(308.0±198.8)ms、(227.2±193.8)ms、(10.9±6.3)%、(32.9±21.9)%减低,差异有统计学意义(t=2.597～3.216,P均<0.05)。冠心病组PCI治疗前基底段前壁、中间段前壁、心尖段前壁rLVEF分别为(46.2±33.6)%、(48.2±17.0)%、(48.7±16.8)%,健康对照组的rLVEF为(65.0±15.0)%、(63.9±20.7)%、(70.3±15.8)%,两组比�Objective The left ventricular synchrony and systolic function were assessed in patients with coronary artery disease before and after percutaneous coronary intervention(PCI)by real-time three-dimensional echocardiography(RT-3DE).Methods A total of 20 healthy volunteers were performed RT-3DE,and twenty patients with coronary artery disease had RT-3DE before PCI.RT-3DE follow-up was performed 1 week after PCI in all patients with coronary artery disease.Full-volume imaging was recorded before and 1 week after PCI and the data was analyzed by Qlab 6.0 Offline analysis software.A series of global and regional left ventricular volume curves were plotted.The parameters of left ventricular systolic function and regional left ventricular ejection fraction(rLVEF)were calculated.The parameters of left ventricular synchrony:Tmsv-16-sd、Tmsv-12-sd、Tmsv-16-dif、Tmsv-12-dif、Tmsv-16-sd%、Tmsv-12-sd%、Tmsv-16-dif%、Tmsv-12-dif% were obtained by offline analysis software.A paired student's t test was used to compare the dates of coronary artery disease before PCI versus follow-up.Independent-samples t test was used to compare the dates between control group and the group of coronary artery disease.Results All the systolic synchrony parameters Tmsv-16-sd,Tmsv-12-sd,Tmsv-16-dif,Tmsv-12-dif,Tmsv-16-sd%,Tmsv-12-sd%,Tmsv-16-dif% and Tmsv-12-dif% were significant larger in patients with coronary artery disease than those of the control group[(149.2±15.7)ms vs(23.8±20.7)ms,(77.5±63.0)ms vs(15.6±21.3)ms,(308.0±198.8)ms vs(81.9±73.1)ms,(227.2±193.8)ms vs(65.6±90.3)ms,(10.9±6.3)% vs(2.6±2.4)%,(32.9±21.9)% vs(11.2±11.7)%,(24.1±22.1)% vs(6.9±8.6)%,t=-3.714^-6.588,P<0.05].After treated with PCI,the Tmsv-16-sd,Tmsv-12-sd,Tmsv-16-dif,Tmsv-12-dif,Tmsv-16-sd% and Tmsv-16-dif% of coronary artery disease patients were lower than those before PCI[(58.8±50.1)ms vs(149.2±15.7)ms,(43.7±54.6)ms vs(77.5±63.0)ms,(192.8±160.8)ms vs(308.0±198.8)ms,(126.9±162.7)ms vs(227.2±193.8)ms,(7.0±6.4)% vs(10.9±6.3)%,(21.7±19.9)% vs(3

关 键 词：三维超声心动描记术 经皮冠状动脉介入 左心室功能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]