冠状动脉内支架植入术前后左心室长轴应变率的定量观察  

Quantitative observation of left ventricular longitudinal strain rate before and after PTCA and coronary artery stent implantation

作　　者：陈爱[1] 郑哲岚[2] 张生光[1] 

机构地区：[1]中国人民解放军第98医院特诊科,浙江湖州313000 [2]浙江大学医学院附属第一医院超声科,浙江杭州310003

出　　处：《中国医学影像技术》2010年第6期1061-1064,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨长轴应变率成像(SRI)评价冠状动脉性心脏病(CAD)患者冠状动脉支架植入术前后左心室局部功能变化的临床价值。方法 CAD患者32例,均经冠状动脉造影证实至少有1支冠状动脉主支狭窄≥75%,分别于PTCA支架植入术前1～3天(术前组)、术后(3.0±0.2)个月(术后组)接受超声心动图检查。正常对照组40名。分别测量术前组、术后组、正常对照组左心室基底段和中段的收缩期应变率(SRs)、舒张早期应变率(SRe)、舒张晚期应变率(SRa),并计算平均应变率(mSRs、mSRe、mSRa)。对CAD组与正常对照组,术前组与术后组各参数进行比较。结果术前组左心室心肌12个节段中有10个节段SRe、7个节段SRs及6个节段SRa值较正常对照组明显降低。术后组有8个节段SRs、3个节段SRe较术前组明显增加。以SRs的绝对值0.78s-1为截断值判断左心室节段收缩功能恢复的准确率、敏感度、特异度分别为65.66%、63.57%、67.25%;以SRe0.90s-1为截断值判断左心室局部心肌松弛性恢复的准确率、敏感度、特异度分别为65.68%、65.63%、65.44%。结论 SRs与SRe可用于评价PTCA支架植入术后左心室心肌局部功能恢复。Objective To assess the clinical value of the changes of left ventricular（LV）regional function before and after percutaneous transluminal coronary angioplasty（PTCA）and stent implantation in patients with coronary artery disease（CAD）with longitudinal strain rate imaging（SRI）.Methods Totally 32 patients with at least 1 main branch of coronary artery stenosis（diameter reduction ≥75%）confirmed with coronary angiography and 40 normal subjects were included.All 32 patients underwent echocardiography 1-3 days preoperative（preoperative group,PrG）and（3.0±0.2）months postoperative（postoperative group,PoG）.The peaks of strain rate curve at systole（SRs）,early diastole（SRe）and late diastole（SRa）of the base and mid segments were measured in three groups.The mean SRs,SRe,SRa of all segments were also calculated.Results Compared with normal subjects,SRs of 10 LV segments,SRs of 7 LV segments and SRa of 6 LV segments were lower in PrG.SRe of 8 LV segments and SRs of 3 LV segments in PoG were higher than those in PrG.The accuracy,sensitivity,specificity of SRs for distinguishing LV regional systolic function recovery in PoG was 65.66%,63.57%,67.25% when SRs was 0.78 s-1.The accuracy,sensitivity,specificity of SRe for distinguishing LV myocardial relaxation recovery in PoG was 65.68%,65.63%,65.44% when SRe was 0.90 s-1.Conclusion SRs and SRe can be used to distinguish the recovery of LV regional function after stent implantation.

关 键 词：应变率成像 心室功能 左 冠状动脉疾病 支架 

分 类 号：R540.45[医药卫生—心血管疾病] R541.4[医药卫生—内科学]