腺苷负荷二维应变评价冠心病患者左室整体应变及应变率  

A research of adenosine stress with two-dimensional strain echocardiography in global left ventricular strain and strain rate of CAD

作　　者：吴英[1] 徐宏贵[1] 罗良平[2] 黄君[1] 冯清华[1] 

机构地区：[1]暨南大学附属第一医院超声科,广东广州510630 [2]暨南大学附属第一医院医学影像中心,广东广州510630

出　　处：《暨南大学学报（自然科学与医学版）》2011年第6期641-646,共6页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：广东省科技计划项目(2010B031600104)

摘　　要：目的:探讨腺苷负荷结合二维应变超声心动图(two-dimensional strain echocardiography,2DSE)对冠心病患者左室整体应变及应变率的应用价值。方法:共入选15例经冠脉造影证实的冠心病患者,分别静脉注射腺苷注射液[140μg.(kg.min)-1],用药时间6 min(总剂量为0.8 mg/kg)。分别于腺苷注射液给药开始、给药后3min、终止给药时和停药后5 min完成左心室短轴及长轴各切面的二维图像采集。应用Echo-PAC超声工作站分析左室心肌整体应变和应变率,比较腺苷负荷前(n=15)和负荷峰值剂量(n=15)左室短轴及长轴各切面心肌整体应变的改变。结果:与负荷前比较,负荷峰值下左室各切面心肌整体收缩期应变(GS)、收缩期应变率(GSRs)低于负荷前,舒张早期应变率(GSRe)、舒张晚期应变率(GSRa)、GSRe/GSRa比值则高于负荷前。除外GSRe/GSRa比值,其余各应变值差异均有统计学意义(P<0.05);组间各时间段两两比较,左室整体应变值差异有显著性意义(P<0.01);组内各切面间两两比较,应变值差异不明显(P>0.05)。试验中不良反应发生率为86.0%,但症状轻微,腺苷负荷试验安全性良好。结论:腺苷负荷超声心动图结合心肌二维应变可定量分析心肌运动规律,可为临床评价心功能提供有效的量化手段。Aim：To investigate the application value of adenosine stress with two-dimensional strain echocardiography （2DSE） in global left ventricle strain and strain rate of coronary artery disease（CAD）. Methods： Fifteen cases of coronary artery disease confirmed by coronary angiography were se-lected in the study. All of them accepted the injection of adenosine [ 140 μg · （kg · min）^-1 ] for six mi-nutes （total dosage： 0. 8 mg/kg） intravenously. The two-dimensional pictures of short-axis and long-axisviews of left ventricle would be picked at the time of the beginning, 3 minutes end, 6 minutes end, andafter the injection 5 minutes of the experiment respectively. The myocardium strain between the baseline（ n = 15 ） and adenosine stress（ n = 15 ） tests were analyzed by the Echo-PAC workstation after the experi-ment. Results： The adenosine stress test had a good safety. Compared with the baseline, the systolicglobal straining （GS） and systolic global straining rate （GSRs） were lower than the control group, how-ever, the earlier diastolic global strain rate （GSRe）, advanced diastolic global strain rate （GSRa）, andthe ratio between GSRe and GSRa （GSRe/GSRa） increased. Except the GSRe/GSRa ratio, The differ-ences of the others were statistically significant （ P 〈 0. 05 ）. After the two-two comparison, the strain val-ue of left ventricular at each time point between the two groups was different. The differences were statis-tically significant （P 〈0. O1 ）, however, there was no obvious difference in each section of left ventricu-lar within groups （P 〉 0. 05 ）. In this experiment, the incidence of adverse reaction was 86%. Thesymptoms of the patients were mild and no serious adverse events. Conclusion：The ASE combined withmyocardial two-dimensional strain can analyze the movement rules of myocardium quantitatively. It is aneffective method to assess cardiac function for clinical departments.

关 键 词：腺苷 负荷超声心动图 二维应变 冠心病 

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