三维斑点追踪技术评价冠心病患者左心室心肌特性改变  

Clinical value of three dimensional speckle tracking imaging in evaluating the changes of myocardial characteristics of left ventricle in patients with coronary heart disease

作　　者：李林[1] 张平洋[1] 冉红[1] 马小五[1] 董静[1] 万林林[1] 

机构地区：[1]南京医科大学附属南京医院(南京市第一医院),南京市210029

出　　处：《河北医药》2017年第9期1297-1300,共4页Hebei Medical Journal

基　　金：南京市卫生青年人才培养经费资助项目(编号:QRX11034)

摘　　要：目的应用三维斑点追踪技术(three dimensional speckle tracking imaging,3D-STI)分析冠心病患者左心室整体应变特性,探讨该技术评价冠心病患者左心室心肌特性改变的临床价值。方法选取经冠状动脉造影证实的冠心病患者40例(心肌梗死患者不纳入研究)作为研究对象,并随机选取年龄、性别相匹配的经冠状动脉造影证实的正常人32例做对照组。所有受试者行二维及三维超声心动图检查。采用二维双平面Simpson法测量受试者的左心室每搏量(SV)及左心室射血分数(LVEF),应用三维斑点追踪技术测量2组的左心室整体长轴应变值(GLS)、圆周应变值(GCS)、径向应变值(GRS)、面积应变值(GAS)以及三维应变(3D-Strain),对2组间参数进行比较,并对各参数与LVEF之间的相关性进行分析。结果冠心病组患者与正常对照组[(46.23±7.37)ml VS(49.67±8.37)ml,P=0.096]、LVEF[(57.17±3.41)%VS(58.87±3.69)%,P=0.069]差异无统计学意义(P>0.05)。与正常对照组相比,冠心病患者GLS[(-14.95±2.61)%VS(-18.37±3.09)%,P<0.01]及GRS[(39.42±4.95)%VS(44.11±6.10)%,P=0.002]均明显减小(P<0.05);GCS[(-15.53±3.63)%VS(-17.21±3.60)%,P=0.076]略微减小,但差异无统计学意义(P>0.05);GAS[(-26.43±3.01)%VS(-30.27±3.29)%,P<0.01]、3D-Strain[(42.92±3.86)%VS(45.90±3.52)%,P=0.003]均显著减小(P<0.05)。相关性分析表明GLS、GCS、GAS与LVEF之间呈负相关(r分别为-0.667、-0.651、-0.685,P<0.01),GRS、3D-Strain与LVEF之间呈正相关(r分别为0.640、0.646,P<0.01)。结论实时三维斑点追踪技术能够更加便捷、准确的反映冠心病患者的左心室心肌特性的变化。Objective To analyze the global strain characteristics of left ventricle in patients with coronary heart disease （CHD） by means of three dimensional speckle tracking imaging （ 3D-STI） , and to explore the clinical value of 3D-STI in evaluating the changes of myocardial characteristics of left ventricle. Methods Forty patients with CHD confirmed by coronary arteriography excluding the patients with myocardial infarction were enrolled as CHD group,at the same time, the other 32 healthy subjects with the same age and sex as those in CHD group were served as control group. All the subjects underwent 2D-echocardiography and three dimensional echocardiography （3DE）. The stroke volume （SV） and left ventricular ejection fraction （LVEF） were detected by two dimensional biplane Simpson method,moreover, the longitudinal peak systolic strain （GLS） ,circumferential peak systolic strain （GCS） ,radial peak systolic strain （GRS） ,area peak systolic strain （GAS） and three dimensional peak systolic strain （3D-Strain） were measured by 3D-STI. The detection results were analyzed and compared between two groups, moreover, the correlation between these parameters and LVEF was analyzed. Results There were no significant differences in SV and LVEF between CHD group and control group, SV[ （ 4 6 . 23 ± 7. 37 ） ml vs （4 9 . 67 土 8.37） ml, P 〉0. 05 ] ,LVEF[ （57. 17 ± 3.41） % vs （58. 87 ± 3. 69） % y P 〉 0. 05 ] . As compared with those in control group, tlieGLSandGRSinCHDgroupweresignificantlydecreased,GLS[（ - 1 4 . 9 5 ± 2 . 6 1 ） % vs （ - 1 8 . 3 7 ± 3 . 0 9 ） %, P 〈0.01] and GRS [（39. 42 ±4. 95） % vs （44. 11 ±6.10） %,P 〈0.01]. Moreover GCS in CHD group was lower than that in control group,however,there was no significant difference between CHD group and control group [ （ -15. 53 ±3. 63） % vs （ - 17. 21 ± 3. 60） %,P 〉 0. 05 ]. Besides GAS and 3D-Strain in CHD group were significantly decreased,as comparedwith th

关 键 词：三维斑点追踪 超声心动图 应变 冠心病 心肌特性 

分 类 号：R540.45[医药卫生—心血管疾病]