定量组织速度成像对冠心病患者PTCA支架置入后左心室功能及其同步性的评价  

Assessment of left ventricular function and synchrony in patients with coronary disease after PTCA and stent implantation by quantitative tissue velocity imaging

作　　者：丁康[1] 曹铁生[2] 王树贤[1] 罗玉君[1] 徐艳燕[1] 张立霞[1] 

机构地区：[1]解放军第三零五医院超声科,北京100017 [2]第四军医大学唐都医院超声科

出　　处：《中华超声影像学杂志》2010年第12期1026-1029,共4页Chinese Journal of Ultrasonography

基　　金：总后军队＂十一五＂计划B类课题（06MB350）

摘　　要：目的 应用定量组织速度成像（QTVI）技术探讨冠心病患者PTCA支架置入后缺血节段心肌运动的同步性变化及其对心功能的影响.方法 左前降支单支病变狭窄率≥75%患者36例,分别于支架治疗前3 d及治疗后1周、1个月应用Q TVI曲线测量左室心肌5个节段的收缩期峰值速度（Vs）、舒张早期峰值速度（Ve）、舒张晚期峰值速度（Va）、收缩期同步性指标（Ts）并计算Ts标准差（Ts-SD）.结果 冠心病患者各节段Vs、Ve、Va值均较低,Ve/Va倒置;支架置入治疗1周后,各节段Vs、Ve值均较术前升高（P＜0.05）,Ve/Va值恢复.治疗后1月.速度指标继续增高,Vs、Ve均较术前差异有统计学意义（P＜0.01）,与治疗后1周比较（P＜0.05）,Va均无明显变化.术前不同步指标Ts明显延长.治疗后1周、1月均较术前明显缩短,差异有统计学意义（分别P＜0.05.P＜0.01）.结论 QTVI技术能够定量分析冠心病患者缺血心肌运动及室壁同步性,监测PTCA术后心脏功能和同步性变化.Objective To evaluate the left ventricular function and the synchrony of myocardial ischemic segments in patients with coronary heart disease （CHD） after PTCA and stent implantation by quantitative tissue velocity imaging （QTVI）. Methods Thirty-six patients with isolated left anterior descending stenosis （≥75%） were examined by QTVI three days before, one week and one month after successful PTCA and stent implantation to measure the following items of 5 different left ventricular segments： peak systolic velocity（ Vs）, early diastolic velocity （Ve）, late diastolic velocity （Va）, time to peak systolic velocity（Ts）. Then the coefficient of variation （SD/mean） of the 5 different Ts were calculated.Results The value of Vs,Ve and Va were decreased and the Ve/Va ratio was reverses three days before PTCA ＋ stent. Compared with that before PTCA ＋ stent,the value of Vs and Ve were increased significantly in one week （ P ＜0. 05） and one month（ P ＜0.01 ） after PTCA ＋ stent,respectively,the value of Va was not statistically significant. Ve/Va ratio was recovered in one week after PTCA treatment. Ts and Ts-SD were shorted dramatically in one week（ P ＜0. 05） and one month（ P ＜0.01 ） after PTCA ＋ stent compared with that before PTCA ＋ stent in which Ts were prolonged more than 33 ms. Conclusions QTVI can quantitatively assess the left ventricular function and the synchrony of myocardial ischemic segments, and can be used to real-time detect the changes of function and synchrony of left ventricle after PTCA and stent implantation.

关 键 词：超声心动描记术 冠状动脉疾病 支架 心室功能 左 

分 类 号：R686[医药卫生—骨科学]