超声二维斑点追踪技术定量评价不同部位心肌梗死患者心功能的研究  

Quantitative Evaluation of Cardiac Function in Myocardial Infarction by 2-dimensional Speckle Tracking Echocardiography

作　　者：张慧[1] 王禹[1] 王秋霜[1] 张梅青[1] 姬冬冬[1] 孟娟娟[1] 张丽伟[1] 沈东[1] 张春红[1] 

机构地区：[1]解放军总医院第一附属医院心血管内科,北京市100037

出　　处：《中国康复理论与实践》2010年第4期349-351,共3页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的探讨对于不同部位心肌梗死,超声二维斑点追踪技术定量判断局部室壁运动异常及心脏整体收缩功能状态的临床应用价值。方法二维超声记录左室长轴和短轴切面高帧频图像,应用超声二维斑点追踪技术测量左室心肌各节段纵向、径向、圆周应变值。结果与正常对照组对比,前壁心肌梗死组左室16/17节段的纵向应变值、11/18节段的径向应变值、12/18节段的圆周应变值减低,其中前、侧壁、室间隔及心尖部应变值减低较其余节段更为显著(P<0.05);下壁心肌梗死组左室15/17节段的纵向应变值、5/18节段的径向应变值、10/18节段的圆周应变值减低,其中下、后壁应变值减低较其余节段更为显著(P<0.05)。前壁心肌梗死组平均纵向应变、平均圆周应变及平均径向应变值均与左室射血分数(Left ventricular ejection fraction,LVEF)值显著相关(r=-0.74,r=-0.78,P<0.001;r=0.69,P<0.05),下壁心肌梗死组仅平均纵向应变值与LVEF值显著相关(r=-0.82,P<0.05)。结论超声二维斑点追踪技术是准确、定量评价心脏局部室壁运动异常及整体收缩功能新的无创方法。纵向应变值可能是全面、准确、定量评价心功能的指标,而圆周及径向应变值的作用则有待进一步研究。Objective To evaluate the accuracy and value of the 2-dimensional （2D）speckle tracking echocardiography quantitative measurement of regional wall motion abnormalities and global systolic function in myocardial infarction（MI） patients with different infarction portions.Methods Left ventricular long axis and short axis view of high frame rate images were recorded with two-dimensional echocardiography,and myocardial segmental longitudinal strain（LS）,radial strain（RS） and circumferential strain（CS） were measured with speckle tracking echocardiography.Results Compared with normal subjects,LS,RS and CS reduction in the proportion of the number of segments were 16/17,11/18 and 12/18 in the anterior wall MI group,of which the strain of anterior,lateral,septal,and apical segments reduced more significantly（ P〈0.05）; And LS,RS and CS reduction in the proportion of the number of segments were 15/17,5/18 and 10/18 in the inferior wall MI group,of which the strain of inferior,posterior segments reduced more significantly（ P〈0.05）. In the anterior wall MI group,the average LS,the average CS,and the average RS were significantly correlated with LVEF（r=-0.74,r=-0.78,P〈0.001; r=0.69,P〈0.05）,in the inferior wall MI group,only the average LS was significantly correlated with LVEF（r=-0.82,P〈0.05）.Conclusion 2D speckle tracking echocardiography is a new non-invasive method that could accurately and quantitatively evaluate the regional wall motion abnormalities and global systolic function. LS may be a comprehensive,accurate,and quantitative evaluation indicator of cardiac function,while the value of RS and CS need to be studied further.

关 键 词：超声二维斑点追踪技术 应变 节段性室壁运动异常 心室功能 

分 类 号：R541[医药卫生—心血管疾病]