斑点追踪技术评价冠状动脉搭桥术后心肌功能的临床价值研究  

Evaluation of Myocardial Function after Coronary Artery Bypass Graft using Speckle Tracking Imaging

作　　者：殷哲煜[1] 董晓秋[1] 刘宏宇[2] 张国伟[2] 刘宗鸿 连杰[1] 徐立伟[1] 刘新颖[1] 王璐璐[1] 

机构地区：[1]哈尔滨医科大学附属第四医院超声科,黑龙江哈尔滨150001 [2]哈尔滨医科大学附属第一医院心脏外科,黑龙江哈尔滨150001

出　　处：《现代生物医学进展》2014年第25期4903-4906,共4页Progress in Modern Biomedicine

基　　金：黑龙江省卫生厅指导项目(2006-231)

摘　　要：目的：探讨超声斑点追踪成像技术定量评价冠状动脉搭桥术前、后心肌功能的临床价值。方法：选择2012 年1 月～2013 年1 月在我院心脏外科行体外循环下冠状动脉旁路移植术的患者，对冠状动脉搭桥术术前1 周、术后1 月、3 月、6 月进行常规超声心动图检查，然后应用斑点追踪技术进行分析。结果：所有患者的纵向应变值仅在术后3 个月和6 个月显著增加，与术前、术后1个月比较差别有统计学意义（P〈0.01）。圆周应变值在术后1个月、3 个月和6 个月均显著增高，与术前比较差别有统计学意义（P〈0.05）。老年组术后6 个月的纵向应变值和圆周应变值与术后3 个月比较差别有统计学意义（P〈0.05）。手术前、后常规超声心动图检查结果比较差别无统计学意义（P〉0.05）。结论：超声斑点追踪技术用于评估CABG 术后缺血心肌的功能变化的敏感性高于常规超声心动图检查，为临床评价CABG的疗效提供了一种新方法。Objective： To investigate the clinical significance of speckle tracking imaging in the quantitative evaluation of myocar- dial fimction of patients after coronary artery bypass graft surgery （CABG）. Methods： In this study, patients who underwent CABG in the department of cardiac surgery from January 2012 to January 2013 were selected, all the patients （left ventricular ejection fraction 〉 50%） were classified into two groups based on the age： elderly group（〉60 years old） and non-elderly group（〈 60 years）. The conventional echocardiography, longitudinal strain and circumferential strain were measured by STI analysis 1 week before CABG and 1, 3, 6 months after CABG. Results： The longitudinal strain increased significantly at 3 and 6 months after CABG compared with that pre-operation（P〈 0.05）. The circumferential strain of both groups increased significantly at 1, 3 and 6 months after CABG, compared with that baseline （P 〈0.05）. But in the elderly group, the longitudinal strain and circumferential strain increased significantly at postoperative 6 month compared with that postoperative 3 month （P〈0.05）. However, no significant difference was found in the left ventricular end-diastolic di- mension（LVEDd）, left ventricular ejection fraction（LVEF） and stroke volume（SV） measured by routine echocardiography between pre- and post-CABG （P 〉 0.05）. Conclusion： Speckle tracking technology was more sensitive to evaluate the myocardial fimction after CABG than conventional echocardiography, and provided a new method for the evaluation of CABG efficacy in clinic.

关 键 词：超声心动图检查 斑点追踪技术 冠心病 冠状动脉搭桥术 心肌功能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R54[医药卫生—诊断学]