二维斑点追踪显像技术评价冠状动脉支架置入术后左心房功能的变化  

Assessment of changes in left atrial function by two-dimensional speckle tracking imaging after intracoronary stent implantation

作　　者：李承宗[1] 胡晓芹[1] 陆远[1] 张超群[1] 徐晤[1] 杨煜[1] 

机构地区：[1]徐州医学院附属医院心内科,江苏徐州221002

出　　处：《徐州医学院学报》2015年第10期714-718,共5页Acta Academiae Medicinae Xuzhou

摘　　要：目的：探讨二维斑点追踪显像（2DSTI）及实时三维超声心动图（ RT3DE）技术评价冠心病患者冠状动脉支架置入术后左心房功能的变化。方法选取30例在心内科住院的冠心病（ CHD）患者，均成功实施冠状动脉支架置入术。分别采集术前、术后1个月和3个月的二维超声心动图、多普勒超声心动图及RT3DE图像。应用改良的Simpson′s法测量左心室射血分数（LVEF）。应用2DSTI技术测定左心房应变率曲线，分别测量收缩期左心房应变率（SRs）、舒张早期左心房峰值应变率（SRe）、舒张晚期左心房应变率（SRa），并计算其平均值（mSRs、mSRe、mSRa）。应用RT3DE测量左心房最大容积（LAVmax）、左心房最小容积（LAVmin）、左心房收缩前容积（LAVp），并计算左心房主动射血分数（LAAEF）和左心房被动射血分数（LAPEF）。结果①与术前比较，冠状动脉支架置入术后1个月LAVmax减小（P＜0．01），LAVmin、LAVp、LAAEF减小（P＜0．05），LAPEF、LVEF增大（P＜0．05）；mSRs和mSRe增高（P＜0．05），mSRa降低（P＜0．05）。与术前比较，冠状动脉支架置入术后3个月LAVmax、LAVmin、LAVp、LAAEF 均减小（P ＜0．01），LAPEF、LVEF增大（P＜0．01）；mSRs 和 mSRe 增高（P ＜0．01），mSRa降低（P＜0．01）。②与术后1个月比较，术后3个月LAVmax 减小（P ＜0．01），LAVmin、LAVp、LAAEF减小（P＜0．05），LAPEF、LVEF增大（P＜0．05）；mSRs和mSRe增高（P＜0．05），mSRa降低（P＜0．05）。结论①CHD患者左心房储备功能和管道功能减低，辅助泵功能增强。②冠状动脉支架置入术后1个月，左心房功能较术前得到改善，表现为左心房储备功能和管道功能增强，辅助泵功能恢复；术后3个月左心房功能进一步改善。Objective To assess the changes in left atrial function by two-dimensional speckle tracking imaging （2DSTI） or real-time three-dimensional echocardiography （RT3DE） in coronary heart disease （CHD） patients after intracoronary stent implantation.Methods A total of thirty CHD patients hospitalized in Department of Cardiology were enrolled in the current study after successful intracoronary stent implantation.Then, images were collected through two-dimensional echocardiography, Doppler echocardiography and RT3DE before and one month and three months after opera-tion.Left ventricular ejection fraction （ LVEF） was measured by a modified Simpson′s method.The peak strain rate of systolic, and early and late diastolic （SRs, SRe, and SRa） of the left atrium were examined by 2DSTI, while their aver-age values were calculated （ mSRs, mSRe, and mSRa） .Meanwhile, left atrial maximal, minimum and pre-systolic vol-umes （ LAVmax, LAVmin and LAVp） were measured by RT3DE, while left atrial active and passive ejection fractions （ LAAEF and LAPEF） were calculated.Results One month after intracoronary stent implantation, patients produced remarkable decreases in LAVmax （P〈0.01）, LAVmin, LAVp, LAAEF and mSRa （P〈0.05）, as well as substantial-ly increases in LAPEF, LVEF, mSRs and mSRe （P〈0.05）, compared with those before operation.Three months after intracoronary stent implantation, patients produced remarkable decreases in LAVmax, LAVmin, LAVp, LAAEF and mSRa （P〈0.01）, as well as substantially increases in LAPEF, LVEF, mSRs and mSRe （P〈0.01）, compared withthose before operation.Three months after operation, decreases were observed in LAVmax （P〈0.01） and LAVmin, LAVp, LAAEF and mSRa （P〈0.05）, while increases were found in LAPEF, LVEF, mSRs and mSRe （P〈0.05）, in comparison with the values obtained one month after operation.Conclusions CHD patients show weakened reservoir and conduit functions of the left atrium and enhanced pump function.The left atrial func

关 键 词：左心房功能 斑点追踪显像 冠状动脉粥样硬化性心脏病 

分 类 号：R541.4[医药卫生—心血管疾病]