组织同步成像评价心肌梗死患者左心室收缩同步性的研究  

Assessment of ventricular systolic asynchrony in myocardial infarction patients by tissue synchronization imaging

作　　者：李岩密[1] 李越[1] 张筠[1] 李蕾[1] 

机构地区：[1]解放军总医院超声科,北京100853

出　　处：《中华超声影像学杂志》2007年第4期282-285,共4页Chinese Journal of Ultrasonography

摘　　要：目的 通过组织同步成像（TSI）探讨前壁心肌梗死（心梗）患者和下壁心梗患者的左心室收缩运动的同步性，以及不同梗死部位对心肌同步性和心功能的影响。方法对60例健康人、30例前壁心梗及28例下壁心梗患者进行超声心动图检查。TSI测量左室心肌12个节段的收缩期达峰值速度时间（Ts），计算12节段Ts的标准差（Ts—SD）和12节段的最大和最小时间的差值（Ts—diff）。结果 对照组Ts—SD及Ts—diff最小。前壁心梗组及下壁心梗组的Ts—SD明显长于对照组（P〈0．05）。Ts—diff在前壁心梗组及下壁心梗组明显大于对照组（PG〈0．05）。心力衰竭心梗组的Ts—SD大于心功能正常心梗组（P=0．053）。心梗患者的Ts—SD及Ts—diff与QRS的宽窄无明确关系。前壁心梗组的前壁和前间隔的Ts明显长于对照组及自身其他心肌节段（P〈0．05）。下壁心梗组的下壁和后壁Ts明显长于对照组及自身其他心肌节段（PG〈0．05）。心梗组的侧壁Ts长于对照组（PG〈0．05）。结论 TSI能够快速定量分析心梗患者室壁运动的时间延迟，其检测的参数与QRS间期的宽度无明显关系。不同部位的心肌梗死均影响心肌的同步性，最延迟Ts取决于不同的梗死部位。Objective To assess the systolic asynchrony in myocardial infarction（MI） patients,and the influence of infarction region to left ventricular systolic asynchrony and heart function by tissue synchronization imaging（TSI）. Methods TSI was performed in 30 anterior MI,28 inferior MI patients and 60 healthy volunteers. Time to peak systolic velocity（Ts） were measured,the standard deviation of Ts（Ts- SD） and the maximal temporal difference of Ts（Ts-diff） were computed. Results Ts-SD and Ts-diff were shortest in control group. The Ts-SD was significantly prolonged in the anterior MI group and inferior MI group when compared with controls （ P 〈 0.05）. Ts-diff was significantly prolonged in MI group when compared with controls（ P 〈0. 05）. Ts-SD in heart failure MI group was longer than non-heart failure MI group（ P = 0. 053）. In MI group,Ts-SD and Ts-diff did not correlate with the duration of QRS complexes. Ts delayed in anterior segments and interventricular septum in anterior MI group（ P 〈0.05）. Ts delayed in inferior and posterior segments in inferior MI group（ P 〈0.05）. Ts of lateral was prolonged in the MI group compared with controls（ P 〈0. 05）. Conclusions TSI allows quick evaluation of regional wall delay in MI patients and it is irrespective of QRS duration. Myocardial infarction has a significant impact on left ventricular synchronicity. The left ventricular systolic delay is mainly determined by the infarction regional.

关 键 词：超声心动描记术 心肌梗塞 心室功能 左 组织同步成像 

分 类 号：R686[医药卫生—骨科学]