三维斑点追踪技术评价冠状动脉病变严重程度临床价值研究  

Clinical significance of assessment of coronary artery stenosis degree by three-dimensional speckle tracking

作　　者：李春艳 刘稳刚[2] 

机构地区：[1]湖南省胸科医院超声科,湖南长沙410013 [2]中南大学湘雅三医院

出　　处：《社区医学杂志》2017年第12期1-3,共3页Journal Of Community Medicine

摘　　要：目的探讨三维斑点追踪技术(3 dimensional speckle tracking,3DST)在诊断冠心病和评估冠状动脉狭窄程度方面的临床应用价值。方法选择2015年8月—2016年3月行冠状动脉造影,确诊为冠心病的患者43例,根据Gensini评分分成轻度病变组14例,中度病变组14例,重度病变组15例;选择冠状动脉造影阴性已排除冠心病,并排除心肌疾病、心脏瓣膜病者40例为对照组,采用三维斑点追踪技术评价各组临床指标及左心室整体收缩期应变均值、心肌节段的旋转及扭转角度,计量资料比较采用t检验,计数资料采用χ~2检验,采用Pearson法做相关性分析,以P<0.05为差异有统计学意义。结果对照组与冠心病组各项临床特征比较,重度病变组LVEDV、LVEF与对照组比较差异均有统计学意义(t=12.630、9.585,均P<0.05),重度病变组GCS、GRS、GLS评分较其他各组都有不同程度下降,随着冠状动脉病变加重,心肌旋转及扭转角度有下降趋势,患者左心室整体应变参数与冠状动脉Gensini评分之间的有相关性(r=0.722、0.495、0.674,均P<0.05),患者心肌旋转、扭转度数与冠状动脉Gensini评分之间的有相关性(r=0.578、0.409、0.603,均P<0.05)。结论三维斑点追踪技术在诊断冠心病和评价冠状动脉病变严重程度方面有一定价值。Objective To evaluate the application value of three-dimensional speckle tracking（3DST） in the assessment of coronary artery stenosis degree. Methods Selected 43 cases with coronary heart disease as the coronary artery disease group, according to the Gensini score, patients were divided into the mild stenosis group（14 cases）, the moderate stenosis group（14 cases） and the severe stenosis group（15 cases）. Selected 40 cases without coronary artery disease,cardiomyopathies and heart valve disease as the control group. The overall strain parameter of left ventricular and myocardial rotation angle of two groups was assessed by 3DST. The data was statistically analyzed by Pearson method, if P〈0.05, difference had statistical sense.Result The difference of LVEDV and LVEF between the severe stenosis group and the control group was statistically significant（t=12.630, 9.585, P〈0.05）. Compared with other groups, the GCS、GRS、GLS scores of the severe stenosis group dropped at different extent. The myocardial rotation angle decreased with coronary artery disease being aggravated, there was significant correlation between strain parameter of left ventricular and Gensini score（r=0.722, 0.495, 0.674, P〈0.05）. There was significant correlation between rotation angle and the degree of coronary artery stenosis and Gensini score（r=0.578, 0.409, 0.603, P〈0.05）. Conclusion 3DST is valuable in the diagnosis of coronary artery disease and the seriousness of coronary artery disease.

关 键 词：三维斑点追踪技术 冠状动脉 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]