急性心肌梗死患者左室整体应变与冠心病指数评分的相关性研究  

Correlation between cardiac two-dimension global strain-speckle tracking imaging and coronary artery disease index scores in patients with acute myocardial infarction

作　　者：徐敏[1] 徐国林[1] 龚明霞[1] 刘飞[1] 孟军[1] 葛志祥[1] 

机构地区：[1]江苏省常州市第一人民医院苏州大学附属第三医院心功能科,213003

出　　处：《中国医师进修杂志》2016年第7期607-610,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的：探讨急性心肌梗死（AMI）患者二维斑点追踪成像（2D-STI）应变指标与冠心病指数（CADi）评分的相关性。方法纳入AMI患者80例，采用心脏超声2D-STI技术进行心肌运动分析，QLAB软件自动计算左室整体长轴应变（GLS）、整体径向应变（GRS）、整体圆周应变（GCS）。根据CADi评分标准对纳入患者的冠状动脉造影结果进行评分，分析2D-STI应变指标与CADi评分的相关性。分别计算GLS、GRS、GCS判断AMI患者冠状动脉重度狭窄（狭窄率≥70％）的受试者工作特征（ROC）曲线下面积（AUC）。结果应变指标GLS、GRS、GCS与CADi评分均相关（r=0.670、－0.621、0.525，P值均＜0.01）。GLS判断重度狭窄的敏感度、特异度及AUC分别为82.35%、80.43%、0.831；GCS判断重度狭窄的敏感度、特异度及AUC分别为76.47%、76.09%、0.797；GRS判断重度狭窄的敏感度、特异度及AUC分别为97.06%、78.26%、0.880。GLS、GRS较GCS的AUC大，诊断冠状动脉重度狭窄的敏感度及特异度亦较高。结论2D-STI应变指标GLS、GRS、GCS与CADi评分具有相关性，GLS、GCS与冠状动脉狭窄程度相关。Objective To observe the correlation between cardiac two-dimension global strain-speckle tracking imaging （2D-STI） and coronary artery disease index （CADi） scores in patients with acute myocardial infarction（AMI）. Methods Eighty patients with AMI were chosen and given myocardial motion analysis using 2D-STI. The global longitudinal strain （GLS）, global radial strain （GRS） and global circumferential strain （GCS） was calculated. All patients were given scoring according to CADi scores standard by coronary angiography. The correlations between 2D-STI indexes and CADi scores were analyzed. The area under curve（AUC） of the receiver operating characteristic curve （ROC） of critical coronary stenosis was calculated. Results GLS, GRS and GCS was all correlated to CADi scores （r=0.670, -0.621, 0.525, all P 〈 0.01）. The sensitivity, specificity and AUC of GLS for critical coronary stenosis was 82.35%, 80.43% and 0.831. The sensitivity, specificity and AUC of GCS for critical coronary stenosis was 76.47%, 76.09% and 0.797. The sensitivity, specificity and AUC of GRS for critical coronary stenosis was 97.06%, 78.26% and 0.880. The AUC of GLS and GRS was larger than that of GCS, and the sensitivity, specificity for critical coronary stenosis was larger. Conclusions 2D-STI indexes have correlation with CADi scores. GLS and GRS has correlation with coronary artery stenosis.

关 键 词：超声心动描记术 冠状动脉狭窄 心血管造影术 应变 

分 类 号：R542.22[医药卫生—心血管疾病] R541.4[医药卫生—内科学]