心肌应变率定量评价冠状动脉支架置入术后梗死心肌局部功能研究  

Clinical Study of the Regional Function Changes of Myocardial Infarction after Coronary Artery Stent Implantation by Strain Rate Imaging

作　　者：白云艳[1] 董晓秋[1] 连杰[1] 毕伟[1] 金丽娟[2] 刘宗泓[3] 

机构地区：[1]哈尔滨医科大学附属四院超声科,哈尔滨市150001 [2]哈尔滨医科大学附属二院心内科 [3]哈尔滨医科大学附属一院心外科

出　　处：《中国超声医学杂志》2009年第9期873-876,共4页Chinese Journal of Ultrasound in Medicine

基　　金：黑龙江省卫生厅基金项目（No.2006-217）

摘　　要：目的 探讨心肌应变率成像（SRI）定量评价冠状动脉支架置入术后左室梗死心肌局部功能变化的临床价值。方法50例心肌梗死（心梗）患者经冠状动脉造影（CAG）证实存在左前降支、回旋支、右冠状动脉狭窄90％以上，分别在冠状动脉支架置入术前、术后1周、术后1个月、3个月及6个月测量梗死心肌及其周边节段心肌应变率即梗死心肌局部功能的变化，半定量法测定梗死心肌的面积并与应变率法测定梗死面积进行比较。结果与术前相比术后1周梗死周边节段心肌应变率均有增加（P〈0．05），而梗死面积及梗死中心节段心肌应变率无明显变化，术后3个月梗死周边心肌应变率明显增加及梗死面积明显减少（P〈0．01），术后6个月梗死周边心肌应变率明显增加梗死面积明显减少（P〈0．01）。结论SRI可以无创定量评价冠状动脉支架置入术后左室局部功能的变化。Objective To explore the clinical value of the regional myocardial function changes after coronary artery stent implantation and to quantitively analyse regional left ventricular myocardial function by strain rate imaging （SRI）. Methods 50 patients were studied using echocardiography. It was confirmed that they all had over 90% ste noses in left anterior descending （LAD）, left circumflex （LCX） and right coronary artery （RCA）. The strain rate of infarctional myocardial and area around were measured and their wall motions were measured in 50 cases preopera-tively and a week, 3 months, 6 months after coronary artery stent implantation. Transthoracic two dimensional, doppler and strain rate imaging echocardiography performed in all study objects. The area of myocardial infarction was measured using semiquantitive method and the results were compared with 50 heathy volunteers. Results Compared with those of before coronary artery stent impalantation, the strain rate of regiomal myocardial a week after coronary artery stent implantation increased （P〈0.05）. The further increase of strain rate and the decrease of area of infarc tion were noticed the third 3 month （P〈0.01）. The further small increase of strain rate and decrease of area of infarction was noticed in the sixth month （P〈0. 01）. Conclusions Strain rate imaging can quantitively evaluate left ventricular regional myocardial functional changes after coronary artery stent implantation.

关 键 词：应变率成像 心肌梗死 冠状动脉支架置入术 局部心肌功能 

分 类 号：R654.2[医药卫生—外科学] R331.31[医药卫生—临床医学]