组织速度 应变率及应变对心肌缺血的诊断价值评价  

The diagnostic value of tissue velocity,strain rate and strain rate imaging for myocardial ischemia

作　　者：董彦[1] 蔡伟[1] 刘淑红[1] 周瑞娟[1] 喻丽华[1] 赵季红[1] 姜铁民[1] 

机构地区：[1]武警医学院附属医院心内科,天津300162

出　　处：《中国实用内科杂志》2010年第7期629-630,633,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的以冠状动脉造影为标准评价组织速度(V)、应变率(SR)及应变(S)对心肌缺血的诊断价值。方法以冠状动脉造影为标准,对2008年6月至2009年3月武警医学院附属医院心内科86例心肌缺血患者分为造影正常组和异常组,测定两组的V、SR、S,对照分析两组患者左室各节段收缩期峰值速度(Vs)、峰值应变率(SRs)、峰值应变(Ss)以及舒张早期峰值速度(Ve)、舒张早期应变率(SRe)和舒张早期应变(Se)对心肌缺血筛查的敏感性和特异性。结果两组Vs数值从基底段至心尖段均呈依次减低趋势,异常组基底段Vs、SRs、Ss值,基底段、中间段Ve值、各节段SRe均低于正常组(P<0.05)。在特异性相近的情况下,对心肌缺血诊断灵敏度高的依次为基底段Ve(76%)、中间段Ve(73%)以及基底段和中间段SRs(均为69%),基底段Ss(64%)。结论应用V、SR及S在早期心肌缺血的无创筛检方面有一定价值。Objective To investigate the diagnostic value of tissue velocity, strain and strain rate imaging for myocardial ischemia. Methods A total of 86 samples come from cardiovascular department, from June 2008 to March 2009, were divided into 2 groups according to the defined result of coronary angiography ： group A （ the coronary arteries were normal）, group B （the coronary arteries were abnormal）. The tissue velocity （V） , strain （S） , strain ratio （SR） were assessed. The sensitivity and specificity of the following index of basement, middle segment, apex of left ventricular to diagnose myocardial ischemia were measured： peak systolic flow velocity （ Vs）, peak systolic strain rate （SRs） ,peak systolic strain （Ss） ,peak early diastole flow velocity （Ve） ,peak early diastole strain rate （SRe） and peak early diastole strain （Se）. Results There were the reduced tendency of Vs from of basement to apex. THE Vs, SRs and Ss of basement, the Ve of basement and middte segment, and the SRe of all segment were higher in group A（ P 〈 0.05 ）. The sequence of sensitivity to diagnose myocardial ischemia in order was ： Ve of basement （76%）, Ve of middle segment （ 73% ）, SRs of basement （ 69% ）, SRs of middle segment （69%） ,Ss of basement （64%） when their specificities were similar. Conclusion There are some value of tissue velocity, strain rate and strain rate imaging for myocardial ischemia in early noninvade diagnose.

关 键 词：组织速度 应变率 应变成像 心肌缺血 

分 类 号：R5[医药卫生—内科学]