二维斑点追踪超声心动图在评价冠脉多支病变患者左心功能中的作用  

The role of two-dimensional speckle tracking echocardiography in evaluating left ventricular function of patients with multi-vessel coronary artery disease

作　　者：米佳[1] 王佳强[2] 闫娟[1] Mi Jia;Wang Jiaqiang;Yan Juan(Department of Ultrasound, Dong guan Branch of Yan' an University Affiliated Hospital, Yan' an 716000,China;Department of Ultrasound Diagnosis, Yan'an University Affiliated Hospital, Yan'an 716000, China)

机构地区：[1]延安大学附属医院东关分院超声科,716000 [2]延安大学附属医院超声诊断科,716000

出　　处：《中国医师杂志》2019年第3期401-405,409,共6页Journal of Chinese Physician

摘　　要：目的探究二维斑点追踪超声心动图在评价冠脉多支病变患者左心功能中的作用。方法将2017年6月至2018年1月本院收治的冠脉多支病变(MVD)且室壁运动无明显异常的患者40例作为研究对象,列为MVD组,另选取42例正常人作为对照组。采用超声心动图检测受试者左房收缩末期前后径(LAd)、左室舒张末期前后径(LVEDD)等各项指标,然后采集所有受试者动态灰阶图像,采用二维斑点追踪技术测量出左室整体收缩期纵向应变值(GLS)、左室整体径向应变值(GRS)、环向应变值(GCS),左室基底段纵向应变值(Bas-GLS)、环向应变值(Bas-GCS)、径向应变值(Bas-GRS),中间段纵向应变值(Mid-GLS)、环向应变值(Mid-GCS)、径向应变值(Mid-GRS),心尖段纵向应变值(Ap-GLS)、环向应变值(Ap-GCS)、径向应变值(Ap-GRS)。结果 MVD组冠脉阻塞或次全阻塞患者中有84. 21%的患者冠脉造影显示侧支形成;常规超声心动图检测各项指标差异无统计学意义(P> 0. 05); MVD组GLS、Bas-GLS、Mid-GLS、Bas-GCS、Mid-GCS、GRS、Bas-GRS与对照组相比均明显降低,差异有统计学意义(P <0. 05)。结论二维斑点追踪技术在评价无室壁活动异常的冠脉多支病变患者时,相对超声心动图而言,可更为敏感地检测出心肌病变,发现心肌收缩功能障碍,其中以心肌纵向收缩功能受损及基底段心肌受损最为明显。Objective To explore the role of two-dimensional speckle tracking echocardiography in evaluating left ventricular function of patients with multi-vessel coronary artery disease (MVD). Methods 40 patients with MVD without obviously abnormal ventricular wall activity admitted to our hospital from June 2017 to January 2018 were selected as the study objects, and were classified as MVD group, and 42 normal persons were selected as the control group. The left atrial end systolic diameter (LAd) and left ventricular end diastolic diameter (LVEDD) were measured by echocardiography, and then the dynamic gray scale images of all patients were collected. The left ventricular global systolic longitudinal strain (GLS), left ventricular global radial strain (GRS), global circumferential strain (GCS), left ventricular basal global longitudinal strain (Bas-GLS), basal global circumferential strain (Bas-GCS), basal global radial strain (Bas-GRS), middle global longitudinal strain (Mid-GLS), middle global circumferential strain (Mid-GCS), middle global radial strain (Mid-GRS), global longitudinal strain of apical segment (Ap-GLS), global circumferential strain value of apical segment (Ap-GCS), and global radial strain value of apical segment (Ap-GRS) were measured by two-dimensional speckle tracking technique. Results In MVD group, 84.21% of patients with coronary artery occlusion or subtotal occlusion showed collateral formation on coronary angiography;there was no significant difference in the indexes detected by conventional echocardiography (P>0.05). The GLS, Bas-GLS, Mid-GLS, Bas-GCS, Mid-GCS, GRS, and Bas-GRS in MVD gro-up were significantly lower than those in control group, with statistically significant differences (P<0.05). Conclusions Compared with echocardiography, two-dimensional speckle tracking technique can detect myocardial lesions more sensitively in patients with coronary multi-vessel disease without abnormal wall activity, and find out the dysfunction of myocardial contraction, especially the damage of longitud

关 键 词：超声心动描记术 冠状动脉疾病 心房功能 左 

分 类 号：R541.4[医药卫生—心血管疾病] R540.45[医药卫生—内科学]