冠心病PTCA术后临床心功能分级与心脏局部及整体功能相关性分析  

Correlation analysis of clinical cardiac function and cardiac function of local and overall in coronary artery disease after PTCA

作　　者：王佳玲[1] 郑逸[2] 阮海东 欧阳斯华[2] 王良玉[2] 

机构地区：[1]汕头市第二人民医院超声科,广东汕头515031 [2]中山大学附属汕头医院超声科,广东汕头515031

出　　处：《东南大学学报（医学版）》2016年第6期943-946,共4页Journal of Southeast University(Medical Science Edition)

基　　金：广东省医学科研基金课题(A2010584)

摘　　要：目的:应用二维斑点追踪技术(2D-STI)检测冠心病PTCA术后局部心脏功能,并与临床心功能分级积分进行相关性分析。方法:随机对70例冠心病PTCA术后患者按纽约临床心功能积分(NYHA-AP)分为临床心功能正常或接近正常组(A组)33例及心功能异常组(B组)37例,比较左室射血分数(LVEF),NYHA-AP,心肌局部心功能指标即左室平均径向应变(MRS)、纵向应变(MLS)、左室心肌收缩期扭转角度(TA)。结果:B组与A组比较,MLS、MRS、TA、LVEF降低(P<0.05)。A组MLS、MRS、TA与LVEF无明显相关性(P>0.05),与NYHA-AP呈负相关(P<0.05);B组MLS、MRS、TA与LVEF及NYHA-AP相关性好(P<0.05)。以MLS-15.30%为截断点判定患者NYHA-AP高于6分灵敏度为90.55%,特异度为72%,Yuedden指数最高0.610。结论:2 D-STI可以检测心肌生物力学参数和左心室局部功能,临床心功能分级与LVEF不同步,与局部心功能参数呈负相关,局部心肌功能参数变化与临床心功能分级同步发展。Objective： To study the left ventricular regional function detected by 2D speckle tracking technology（ 2D-STI） and to analyse the correlation of left ventricular regional function and clinical heart function classification on coronary artery disease after PTCA. Methods： 70 patients with coronary artery disease after PTCA were divided into the clinical heart function normal or approximate normal group（ group A,33 cases） and clinical cardiac dysfunction group（ group B,37 cases）,compared the left ventricular ejection fraction（ LVEF）,New York Heart Association accumulated points（ NYHA-AP）,left ventricular myocardial mean radial strain（ MRS）,longitudinalstrain（ MLS）,left ventricular myocardial systolic torsion angle（ TA） in all the subjects. Results： The MLS,MRS,TA were lower in group B than those in group A（ P 〈 0. 05）. There was no correlation between MLS,MRS,TA and LVEF in group A,but MLS,MRS,TA had positively correlated with LVEF and NYHA-AP in group B. MLS-15. 30% as a cut-off point for determinating NYHA-AP more than 6 points had sensitivity of 90. 55%,specificity of 72%,and the highest Yuedden index of 0. 610. Conclusion： 2D-STI can evaluate regional myocardial function,the clinical cardiac function and left ventricular function parameters LVEF is not synchronized,regional myocardial function parameter variation is simutaneous development with the clinical cardiac function.

关 键 词：冠心病 临床心功能分级 心功能 应变 扭转角度 

分 类 号：R543.3[医药卫生—心血管疾病] R445.1[医药卫生—内科学]