心尖旋转起始波在心尖梗死中变化的超声研究  

Ultrasound Regularity of Initial Wave of Apical Rotation in Apical Infarction

作　　者：郭宝生[1] 任卫东[1] 唐力[1] 陈昕[1] 张立敏[1] 李楠[1] 富维强[1] 

机构地区：[1]中国医科大学附属第一医院心血管检查科,沈阳市110001

出　　处：《中国超声医学杂志》2008年第12期1094-1096,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的观察心尖旋转起始波在心尖梗死中的变化规律并探讨其机制。方法31例心尖梗死患者为研究对象,16例健康志愿者为对照组。用组织多普勒测量心尖短轴切面侧壁及室间隔切线运动速度来计算心尖旋转,前壁及后壁沿声束方向的运动速度来计算心腔半径的变化以准确计算心尖旋转,心尖旋转的计算是根据Notomi等的时间积分公式来进行,大小用幅度表示并用左室长轴径线对其进行校正。心尖心肌应变率用短轴切面侧壁和室间隔二者圆周应变率的平均值表示。比较心尖梗死者与对照组间心尖旋转起始波(心尖旋转-时间曲线的起始负相波,由心尖内层心肌先激动收缩产生)、心尖旋转及应变率的差别。结果心尖梗死者与对照组相比心尖旋转起始波的绝对值显著降低(-0.3°±0.7°及-1.2°±0.7°,P<0.001),心尖旋转显著减低(5.2°±2.7°及9.1°±4.6°,P<0.002),心尖梗死区心肌应变率绝对值显著减低(-0.74s-1±0.28s-1及-2.23s-1±0.74s-1,P<0.001)。心尖梗死者心尖旋转起始波绝对值降低较心尖旋转降低更显著(P<0.01)。结论心尖梗死者心尖旋转起始波绝对值显著减低,其原因为梗死区内层心肌受损较外层更为严重;心尖旋转是心尖心肌的收缩方式之一。Objective To detect the regularity of the initial wave of apical rotation （AR） in apical infarction （AI） and to explore its mechanism. Methods Thirty-one patients with AI were the subject group and 16 healthy volunteers were the control group. With tissue Doppler imaging, AR was calculated with the integrated rotating speeds of left ventricular （LV） lateral wall and interventricular septum. For accurately calculating AR, the changing radius of LV chamber at LV short-axis plane was calculated by the integrated moving speeds of anterior and posterior walls. AR was calculated with Notomi＇s formula. The values of AR were analyzed with the amplitude that was standardized with the LV long-axis length. The strain rate imaging （SRI） of the apex was evaluated with averaged circumferential SRI of LV lateral wall and interventricular septum at apical short-axis plane. The petients＇ initial wave of AR （the negative wave of AR-time curve that is formed by the earlier activation and contraction of apical inner myocardium）, AR and apical SRI were compared with those of the control. Results Compared with the control, the absolut.e value of the initial wave of AR was decreased in AI （-0.3°±0.7°及-1.2°±0.7°,P〈0.001）, AR was decreased （5.2°±2.7°及9.1°±4.6°,P〈0.002）, the absolute values of SRI in AI myocardium significantly was decreased （-0.74s^-1±0.28s^-1及-2.23s^-1±0.74s^-1,P〈0.001） . In AI, the absolute value of the initial wave of AR was decreased more significantly than AR did （P〈 0.01） . Conclusions Absolute value of AR initial wave was significantly decreased in AI ,the cause of which is that the damage in inner layer is more serious than that in outer layer; AR is one pattern of apical myocardial contraction.

关 键 词：心尖旋转起始波 心尖梗死 组织多普勒 应变率 

分 类 号：R542.22[医药卫生—心血管疾病] R542.2[医药卫生—内科学]