斑点追踪技术评价冠心病患者左心室整体及局部收缩功能的研究  

Speckle tracking imaging in assessment for global and regional systolic function in left ventricle in patients with coronary artery disease

作　　者：张绍洁[1] 陈江华[1] 甘书芬[1] 阎国辉[1] 

机构地区：[1]厦门大学附属中山医院超声科,福建厦门361004

出　　处：《第三军医大学学报》2013年第2期165-168,共4页Journal of Third Military Medical University

摘　　要：目的通过二维超声斑点追踪显像(speckle tracking imaging,STI)技术定量分析冠心病患者纵向应变及左室扭转运动,探讨其诊断左室局部及整体收缩功能的临床价值。方法病例组选取2011年2-4月厦门大学附属中山医院心内科行冠脉造影证实至少1支冠状动脉病变≥75%的患者30例(男性21例,女性9例),年龄(63.5±13.7)岁;健康组选择同期我院健康体检者25例(男性17例,女性8例),年龄(57.5±12.3)岁。分别采集心尖左室长轴切面、四腔切面、两腔切面、左室短轴二尖瓣及心尖水平的高帧频二维图像,应用STI软件测量各个节段的纵向应变、平均总应变、左室整体扭转角度、扭转率及扭转达峰时间。结果健康组心肌纵向应变从基底段、中间段至心尖段逐渐增加且差异显著(P<0.05);病例组相应的变化规律消失,各病变节段的纵向应变值均明显低于健康组,平均总应变亦明显低于健康组(P<0.05);以平均总应变值-19%检测≥75%冠脉病变的灵敏度为86.4%,特异度为83.3%。左心室整体扭转角度、扭转率病例组较健康组均显著减低,扭转达峰时间亦显著延迟(P<0.05)。结论超声斑点追踪技术能实时、定量地评价心脏局部及整体的收缩功能,且敏感性高于传统的超声心动图检查,可作为临床冠心病定位诊断、疗效评价及预后判断的无创、客观、有效的检查方法。tively analyzing lon Objective To evaluate the clinical value of speckle tracking imaging（STI） by quantita- gitudinal strain and left ventricular torsion in patient with coronary heart disease （CHD） Methods Thirty patients who had at least one branch of coronary arteries with stenosis over 75% identified with angiography and admitted in Department of Cardiology of our hospital during February to April 2011 were enrolled in this study. Another 25 sex- and age-matched healthy volunteers served as normal control. They all underwent STI examination. Two-dimensional images of the apical long-axis view, four-chamber view, two- chamber view and left ventricular short-axis View at the levels of mitral annulus and apex were recorded. Longi- tudinal strain, average total strain, left ventricular torsion, torsion rate and time to peak were measured. Results In control group, the longitudinal strain was increased along with the distance from the base （P 〈 0. 05 ）. While, CHD patients showed significant reduction in the longitudinal strain, with the longitudinal strain of different sections and the average total strain significantly lower than those in the normal control （P 〈 0. 05 ）. The average total strain value of - 19% had a sensitivity of 86.4% and a specificity of 83.3% when it was used to identify ≥75% coronary lesion. CHD patients showed significant reduction in the torsion, torsion rate, and significantly delayed time to peak（ P 〈 0.05 ）. Conclusion STI is a simple and reliable new method for clinical evaluation of LV regional and global systolic function in patient with CHD.

关 键 词：斑点追踪显像 冠状动脉造影 左心室功能 

分 类 号：R331.31[医药卫生—人体生理学] R445.1[医药卫生—基础医学]