三维斑点追踪面积应变参数评价冠心病患者左心室收缩功能及同步性  

Area strain parameters of speckle tracking imaging quantitatively evaluating the systolic function and synchronization of left ventricle in patients with coronary heart disease

作　　者：冷倩倩[1] 陈金玲[1] 胡波[1] 宋宏宁[1] 郭娟[1] 郭瑞强[1] 

机构地区：[1]武汉大学人民医院超声科,430060

出　　处：《中华超声影像学杂志》2013年第12期1022-1026,共5页Chinese Journal of Ultrasonography

摘　　要：目的应用三维斑点追踪（3D-STI）技术获取冠心病患者左室三维面积应变参数，评价不同冠脉狭窄程度的冠心病患者左室心肌收缩功能及同步性变化，为冠心病患者左室功能及同步性评价提供新依据。方法对94例疑似冠心病患者在冠脉造影术前24h分别进行常规二维超声心动图及3D-STI检查，用三维应变软件对左室图像进行分析。根据冠脉造影结果将其分为重度狭窄组、中度狭窄组和对照组。测量三组的常规超声参数、整体面积应变（AS）、面积应变不同步指数（ASDI），以及AS达峰时间标准差（AS-SD）。结果三组常规超声参数差别无统计学意义（P〉0．05）。与中度狭窄组及对照组相比，重度狭窄组AS明显降低，ASDI及AS-SD明显增高（P〈0．001），而中度狭窄组与对照组AS、ASDI及AS-SD差异均无统计学意义（P〉0．05）。ROC曲线示以ASDI≥1．90％为截断值检测冠心病患者重度冠脉狭窄诊断价值最高，其灵敏度为84．2％，特异度为94．1％。结论3D-STI面积应变参数尤其ASDI可作为评价冠心病左室功能及冠脉狭窄程度的有效参考指标。Objective To obtain area strain parametersuse of left ventricle in patients with coronary heart disease （CHD） by three-dimensional speckle tracking imaging（3D-STI）,evaluate the systolic function and synchronization of left ventricle depending on different degrees of coronary artery stenosis, and then search new evidence for evaluation and diagnosis of the systolic function of left ventricle. Methods 94 patients were recruited diagonosed as CHD were recruited and their 3D-STI dynamic images were stored 24 hours before coronary angiography. All patients were divided into three groups （the severe stenosis group, the moderate stenosis group,and contrast group） according to the results of coronary angiography. Then the conventional echocardiographic parameters, area strain（AS）, area strain dyssynchrony index（ASDI）, and the standard deviation of the peak time of AS（AS-SD） were measured. Results There were no significant differences among conventional echocardiographic parameters of the three groups. Compared to the moderate stenosis group and the contrast group, the AS, ASDI and AS-SD of the severe stenosis group were significant different （ P 〈0. 001）, however there were no differences between the moderate stenosis group and the contrast group （ P〉0.05）. The ROC curve showed that the diagnostic value was the highest to detect severe stenosis when using ASDI≥1. 90% as the cutoff value,with 84. 2% of the sensibility,and 94.1% of the specificity. Conclusions The area strain parameters of 3D-STI are effective indice as clinical references to evaluate the systolic function of left ventricle and the degree of coronary artery stenosis,in particular, the ASDI is the most effective parameter.

关 键 词：超声心动描记术 冠状动脉疾病 心室功能 左 斑点追踪显像 

分 类 号：R541.4[医药卫生—心血管疾病]