二维斑点追踪技术评价心肌梗死患者冠脉内支架术后左室扭转功能变化  

Application of speckle tracking imaging in evaluation of the left ventricular torsion functions in patients with myocardial infarction after percutaneous coronary intervention

作　　者：刘娟[1] 白文伟[1] 李敬[1] 陈卓[1] 

机构地区：[1]昆明医科大学第二附属医院心内科,云南省昆明市650000

出　　处：《中国心血管病研究》2014年第12期1064-1067,1152,共5页Chinese Journal of Cardiovascular Research

基　　金：云南省教育厅科学研究基金项目（项目编号：2010C078）

摘　　要：目的 探讨斑点追踪成像技术（STI）在心肌梗死患者冠脉内支架置入术（PCI）疗效评估中的应用价值.方法 选取2011年3月至2013年5月在昆明医科大学第二附属医院心内科接受PCI治疗的心肌梗死患者30例为病例组,正常对照组35例,对正常对照组及接受PCI治疗的患者在术前,术后1周、1个月、3个月、6个月时进行常规超声心动图检查和斑点追踪成像技术分析,测量左室舒张末期内径（LVDd）、左室舒张末期容积（LVESV）、左室收缩末期容积（LVEDV）,以及左室基底段和心尖段收缩期整体旋转角度峰值（Prot-base、Prot-apex）,并计算左心室扭转角度峰值（Ptw）,比较分析各参数在PCI手术前后的变化,结合分析左室扭转功能的改变.结果 与正常对照组比较,病例组PCI治疗前LVDd、LVESV、LVEDV较对照组扩大,LVEF[（43.74±9.47）％比（58.38±4.37）％]较对照组降低,差异均有统计学意义（P均＜0.05）;与PCI治疗前比较,PCI术后1周、1个月LVDd、LVESV、LVEDV及LVEF都没有明显改变,差异无统计学意义（P均＞0.05）;PCI治疗后3个月、6个月时LVDd、LVESV、LVEDV比PCI治疗前有一定缩小,LVEF[（49.33± 11.06）％比（43.74±9.47）％、（53.74±8.06）％比（43.74±9.47）％]增高,差异均有统计学意义（P均＜0.05）.病例组术前Prot base[（-4.57 ±2.16）°比（-8.18±2.67）°]、Prot apex [（5.17±2.25）°比（9.38±2.72）°]、Ptw[（9.74±3.61）°比（17.56±3.41）°]均显著低于正常对照组（P＜0.05）;病例组术后1周Prot base、Prot apex、Ptw均较术前无明显改善（P＞0.05）.病例组术后1、3、6个月Prot base[（-5.84±2.03）°比（-4.57±2.16）°、（-6.68±2.45）°比（-4.57±2.16）°、（-7.56±2.41）°比（-4.57±2.16）°]、Prot apex [（6.58±2.86）°比（5.17±2.25）°、（7.04±3.12）°比（5.17±2.25）°、（8.75±2.63）°比（5.17±2.25）°]、Ptw [（12.42±4.77）°比（9.74±3.61）°、（13.72±Objective Using speckle tracking imaging technology （STI）,the evaluation of percutaneous coronary intervention（PCI） in patients with myocardial infarction before and after the changes of left ventricular torsion function,to explore the application value of STI in evaluating curative effect of PCI.Methods From 2011 March to 2013 May in Department of Cardiology of myocardial infarction patients treated with PCI and 30 cases of the Second Affiliated Hospital of Kunming Medical University as the case group,35 healthy people as normal control group.The normal control group and PCI group received echocardiography and speckle tracking imaging before PCI and one week,one month,three months,six months after PCI,measured left ventricular diastolic dimension,left ventricular end-diastolic volume,left ventricular end-systolic volume,calculation the values apical rotation,basal rotation and left ventricular twist.The correlations were analyzed before and after PCI with treatment stage in PCI group.Results Compared with the control group,LVDd,LVESV,LVEDV were significantly increased and LVEF[（43.74±9.47）% vs（58.38±4.37）%] were significantly decreased in PCI group before PCI（P〈0.05）.Compared with before the PCI group,LVDd,LVESV,LVEDV and LVEF were not significantly different after one week and one month of PCI（P〉0.05）.Compared with before PCI,LVDd,LVESV,LVEDV were significantly decreased and LVEF[（49.33± 11.06）% vs（43.74±9.47）%,（53.74±8.06）% vs（43.74±9.47）%] were significantly increased in after three months and six months of PCI （P〈0.05）.Compared with the control group,the values apical rotation [（-4.57±2.16）°vs（-8.18±2.67）°],basal rotation [（5.17±2.25）°vs（9.38±2.72）°] and left ventricular twist [（9.74±3.61）°vs （17.56±3.41）°] were significantly decreased in PCI group before PCI （P〈0.05）.Compared with before the PCI group,the values apical rotation,basal rotation and left ventricular twist were not significantly different after one

关 键 词：斑点追踪成像技术 经皮冠状动脉介入治疗 左室扭转功能 

分 类 号：R542.22[医药卫生—心血管疾病]