二维应变率成像技术评价健康人及冠状动脉粥样硬化性心脏病患者左心室局部长轴收缩功能  

Evaluation of left ventricular long axis systolic function in healthy subjects and patients with coronary artery disease by two-dimensional strain rate imaging

作　　者：付秀秀[1] 王志斌[1] 李艳[1] 李勇[1] 

机构地区：[1]青岛大学医学院附属医院心脏超声科,266003

出　　处：《中华医学超声杂志（电子版）》2014年第3期13-17,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的应用二维应变率成像技术检测健康人及冠状动脉粥样硬化性心脏病患者左心室局部长轴收缩功能变化。方法选取2011年10月至2012年8月在青岛大学医学院附属医院心内科住院治疗的冠状动脉粥样硬化性心脏病患者53例,其中前壁供血受损的左前降支病变患者29例(简称LCA组)、下壁供血受损的右冠状动脉病变患者24例(简称RCA组),同时选取健康志愿者30名(健康对照组)。超声心动图采集心尖四腔心、心尖两腔心切面二维动态灰阶图像,测量左心室前壁、侧壁、下壁及室间隔平均纵向收缩期峰值应变率(PSRs)。3组受检者上述资料的比较采用单因素方差分析,组间两两比较采用LSD-q检验。结果健康对照组受检者室间隔与前壁、侧壁、下壁PSRs分别为(4.61±0.60)s-1、(5.18±0.87)s-1、(5.60±0.70)s-1、(6.05±0.74)s-1,差异有统计学意义(F=20.95,P=0.00),且呈现室间隔→前壁→侧壁→下壁逐渐增大的变化规律;LCA组患者室间隔与前壁、侧壁、下壁PSRs分别为(4.31±0.85)s-1、(1.96±0.93)s-1、(5.54±0.83)s-1、(5.93±0.80)s-1,差异有统计学意义(F=127.25,P=0.00),缺血的前壁PSRs明显低于室间隔、侧壁、下壁,且前壁与侧壁、下壁比较,差异均有统计学意义(q=22.62、25.04,P均<0.01);RCA组患者室间隔与前壁、侧壁、下壁PSRs分别为(4.51±0.62)s-1、(4.99±1.13)s-1、(5.31±0.81)s-1、(2.84±0.85)s-1,差异有统计学意义(F=38.12,P=0.00),缺血的下壁PSRs明显低于前壁、侧壁和室间隔,且前壁与下壁比较,差异有统计学意义(q=12.08,P<0.01),侧壁与下壁比较,差异有统计学意义(q=13.88,P<0.01)。同部位各组间比较发现,LCA组前壁PSRs与健康对照组比较,差异有统计学意义(q=20.17,P<0.01);RCA组下壁PSRs与健康对照组比较,差异有统计学意义(q=19.98,P<0.01)。结论二维应变率成像技术能准确评价左心室局部长轴收缩功能的变化,且在健康人中存在一定的变化规律,据此�Objective To evaluate the regional long-axis systolic functlon of lett ventrlcular in patients with coronary artery disease and healthy subjects by two-dimensional strain rate imaging （2D-SRI）. Methods During October 2011 to August 2012,53 inpatients with coronary artery disease in the department cardiology from the Affiliated Hospital of Medical College, Qingdao University were enrolled. Twenty-nine patients with anterior wall infarction induced by left front-descending coronary artery disease （group LCA） and twenty-four with interior wall infarction induced by right coronary artery disease （group RCA） proved by coronary angiography and echocardiography were enrolled into the study and thirty healthy volunteers in the control group. High frame rate two-dimensional dynamic images were recorded in apical four-chamber view and two-chamber view of the left ventricle. Using two-dimensional strain software, peak systolic longitudinal strain rate （PSRs） of interventricular septum, anterior wall, lateral wall and interior wall of left ventricle were measured. All data of 3 groups were analyzed using One-Way analysis of variance, and LSD-q test used to compare the 2 groups. Results The PSRs were （4.61±0.60） s^-1, （5.184±0.87） s^-1, （5.603±0.70） sl, （6.054±0.74） s^-1 from interventricular septum, anterior wall, lateral wall to interior wall in the control group. There were significant differences among the groups （F-20.95, P=0.00）, and there were significant gradient changes from intervetrivular septum, anterior wall, lateral wall to interior wall in the control group. The PSRs were （4.314±0.85） s^-1＂, （1.96±0.93） s^-1, （5.544±0.83） s^-1, （5.934±0.80） s^-1 from interventricular septum, anterior wail, lateral wall to interior wall in the LCA group respectively. There were significant differences among the different walls （F=127.25, P=0.00）, which was significant lower in ischemic anterior wall than interventricular septum, lateral wall and interior wall,

关 键 词：超声心动描记术 冠状动脉疾病 心室功能 左 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]