二维斑点追踪显像评价左前降支不同程度狭窄患者左心室心肌纵向应变价值  

Value of two-dimensional speckle tracking imaging on evaluating left ventricular longitudinal strain in patients with left anterior descending stenosis

作　　者：高亚坤[1] 张玉辉[2] 刘颖[1] 赵磊[3] 李丽[1] 

机构地区：[1]沧州市中心医院超声科,河北沧州061001 [2]沧州市中心医院心胸外科,河北沧州061001 [3]沧州市中心医院心内科,河北沧州061001

出　　处：《中华实用诊断与治疗杂志》2015年第3期250-252,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的探讨应用二维斑点追踪技术（two-dimensional speckle tracking imaging,2D-STI）评价不同程度左前降支（left anterior descending,LAD）狭窄冠心病患者左心室局部及整体纵向应变的价值。方法冠状动脉造影检查显示LAD狭窄患者133例,其中LAD狭窄率≤25%组35例,狭窄率〉25%~50%组28例,狭窄率〉50%~75%组30例,狭窄率〉75%组40例,行2D-STI检查后应用Qlab软件分析4组左心室长轴观、心尖四腔观、心尖两腔观左心室心肌收缩期峰值整体应变（global longitudinal strain,GLs）,LAD参与供血的6个室壁节段（左心室前壁基底段、中间段、心尖段和前间壁基底段、中间段、心尖段）心肌收缩期纵向峰值应变（section longitudinal strain,SLs）,并进行比较。结果 LAD狭窄率≤25%组、狭窄率〉25%~50%组、狭窄率〉50%~75%组应变曲线规则、牛眼图上呈均一红色,狭窄率〉75%组应变曲线紊乱,牛眼图LAD支配节段颜色变为淡粉色;狭窄率〉75%组LAD参与供血的6个室壁节段SLs与其他3组比较差异有统计学意义（P〈0.05）;狭窄率〉75%组左心室长轴观、心尖四腔观、心尖两腔观长轴切面GLs及GLs均值（average GLs,GLs-Avg）分别为（-10.01±3.32、-9.84±3.15、-10.14±3.25、-12.86±4.67）,与狭窄率≤25%组（-20.59±4.23、-19.68±3.52、-20.55±4.20、-21.09±2.61）,狭窄率〉25%~50%组（-19.59±3.53、-18.11±3.18、-19.64±3.72、-20.41±3.26）,狭窄率〉50%~75%组（-17.64±4.31、-15.88±3.06、-18.47±3.28、-18.57±4.51）比较差异均有统计学意义（P〈0.05）;狭窄率≤25%组、狭窄率〉25%~50%组、狭窄率〉50%~75%组上述各指标间比较差异无统计学意义（P〉0.05）。结论应用2D-STI技术可客观定量评价LAD不同程度狭窄患者的左心室心肌纵向应变。Objective To explore the value of two-dimensional speckle tracking imaging（2D-STI）to evaluating regional and global left ventricular longitudinal strain in coronary heart disease（CHD）patients with left anterior descending（LAD）stenosis in different degrees.Methods A total of 133 patients with angiographically confirmed LAD stenosis were divided into 4groups,stenosis rate≤25% group（n=35）,stenosis rate from 〉25% to 〉50% group（n=28）,stenosis rate from 50%to 75% group（n=30）,and stenosis rate 〉75% group（n=40）.All groups were examined by 2DSTI.Qlab software was used to analyze the global longitudinal strain（GLs）of left ventricular systolic peak in the left ventricular long axis view,apical four-chamber view,apical two-chamber view,and the section longitudinal strain（SLs）of systolic peak in the basal segment,middle section,and apex section of left ventricular anterior wall as well as the basal segment,middle section and apex section of anteroseptal wall with blood supplied by LAD branch.Results In coronary stenosis rate≤25%,from 〉25%to 〉50%and from 〉50%to 75% groups,the curves were regular and bull＇s eye was in red and uniform,and SLs showed significant differences in comparison with〉75% group（P〈0.05）.In stenosis rate〉75% group,the curves were irregular and bull＇s eye was in light pink.There were significant differences in SLs of six sections in stenosis rate75% group in comparison with stenosis rate≤25%,from 〉25%to 50%,and from 〉50%to75% groups（P〈0.05）.GLs and average GLs in the left ventricular long axis view,the apical four-chamber view and two-champer view were-10.01±3.32,-9.84±3.15,-10.14±3.25and-12.86±4.67 in coronary stenosis rate〉75% group,significantly different from those in coronary stenosis rate ≤25% group（-20.59±4.23,-19.68±3.52,-20.55±4.20,-21.09±2.61）,coronary stenosis rate from 〉25%to 50% group（-19.59±3.53,-18.11±3.18,-19.64±3.72,-20.41±3.26）,and coronary stenosis rate from 〉50% to 75% group（-17.64�

关 键 词：冠心病 左前降支 二维斑点追踪技术 左心室心肌纵向应变 

分 类 号：R541.4[医药卫生—心血管疾病]