三维斑点追踪成像评价早期冠心病患者左心室收缩功能  

Assessment of Left Ventricular systolic function in patients with coronary artery disease by using three-dimentional speckle tracking imaging

作　　者：史琪[1] 张玲[1] 王春梅[1] Qi SHI;Ling ZHANG;Chunmei WANG(Cardiac Ultrasound Diagnostics Division,The First Affiliated Hospital,Xinjiang Medical University, Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院心脏超声诊断科,新疆乌鲁木齐830011

出　　处：《心血管外科杂志（电子版）》2018年第1期21-24,共4页Journal of Cardiovascular Surgery(Electronic Edition)

基　　金：新疆维吾尔自治区自然科学基金项目(No.2016D01C266)

摘　　要：目的实时三维斑点追踪成像(RT3D-STI)技术对早期冠心病患者左心室收缩功能进行研究,探讨RT3D-STI诊断冠心病的价值。方法 103例疑诊为冠心病的患者根据冠脉造影结果分为冠心病组62例和对照组41例。全部的患者均进行三维超声的心动图检查,对患者的三维全容积图像进行相应的收集和整理,以此得到患者的常规参数和左心室整体的心肌应变值,即为心室的纵向应变(GLS)、径向应变(GRS)、圆周应变(GCS)和面积应变(GAS)等情况。结果将冠心病组患者的基本资料和对照组患者资料进行比较,相关的参数并没显现出差异性(P>0.05);且冠心病组左室整体应变参数(GLS、GCS、GRS、GAS)较对照组而言均减小,变化均有统计学意义(P<0.05);ROC曲线分析显示GLS、GCS、GRS、GAS的灵敏性分为82%、63%、33%、90%;特异性分别为76%、69%、85%、88%,GAS的灵敏性和特异性最高。结论在冠心病患者的左室收缩功能研究中3D-STI的诊断价值可以得到体现,同时面积应变参数作为明显的参考指标,结果可信度较高。Objective Real-time three-dimensional speckle tracking imaging(RT3D-STI)was used to study the left ventricular systolic function in patients with early coronary heart disease(CHD),and to explore the value of RT3D-STI in the diagnosis of CHD.Methods 103 patients suspected of coronary heart disease were divided into coronary heart disease group(62 cases)and control group(41 cases)according to the results of coronary angiography.All patients underwent three-dimensional echocardiographic examination,and the three-dimensional full-volume images were collected and sorted accordingly.The routine parameters of the patients and the myocardial strain values of the left ventricle as a whole were obtained,i.e.longitudinal strain(GLS),radial strain(GRS),circumferential strain(GCS)and area strain(GAS)and so on.Results The basic data of CHD patients were compared with those of the control group,and the related parameters did not show any difference(P>0.05).The left ventricular global strain parameters(GLS,GCS,GRS,GAS)in CHD group were significantly lower than those in control group(P<0.05).ROC curve analysis showed that the sensitivity of GLS,GCS,GRS and GAS was 82%,63%,33%and 90%,the specificity was 76%,69%,85%and 88%,respectively.GAS had the highest sensitivity and specificity.Conclusion The diagnostic value of 3D-STI in the study of left ventricular systolic function in patients with coronary heart disease can be reflected,and the area strain parameters as an obvious reference index,the results have high reliability.

关 键 词：三维斑点追踪成像 冠心病 冠状动脉狭窄 左心室 收缩功能 诊断价值 面积应变 

分 类 号：R541.4[医药卫生—心血管疾病] R445.1[医药卫生—内科学]