自动成像技术评价不同透壁程度急性心肌梗死患者左心室纵向收缩功能  

Automated function imaging for acute myocardial infarction patients with different transmural degree of left ventricular longitudinal systolic function

作　　者：苑欣 菅梅[1] 陈琼[1] 高利 吴宏[1] YUAN Xin;JIAN Mei;CHEN Qiong;GAO Li;WU Hong(Department of Ultrasound, Bayannur Hospital, Bayannur 015000, Inner Mongolia, China)

机构地区：[1]巴彦淖尔市医院超声科,内蒙古巴彦淖尔市015000

出　　处：《生物医学工程与临床》2019年第3期275-279,共5页Biomedical Engineering and Clinical Medicine

基　　金：巴彦淖尔市科技计划项目(K201529)

摘　　要：目的应用自动功能成像(AFI)技术评价不同透壁程度急性心肌梗死(AMI)患者室壁运动特点,探讨其在诊断心肌梗死中的应用价值。方法选择47例首次确诊AMI患者(AMI组),其中男性30例,女性17例;年龄39～77岁,平均年龄56.7岁。选择50例健康体检者(对照组),其中男性36例,女性14例;年龄40～75岁,平均年龄52.1岁。AMI组根据心电图分为非ST段抬高型(NSTEMI)亚组和ST段抬高型(STEMI)亚组。超声心动图获得左心室心尖长轴切面、心尖四腔切面和心尖两腔切面,左心室心尖部、乳头肌、二尖瓣水平各短轴切面的二维灰阶动态图像,通过图像分析测定AFI参数及左心室射血分数(LVEF),进行各组统计学分析。结果 AMI组、NSTEMI亚组、STEMI亚组分别与对照组比较,左心室整体收缩期纵向峰值应变(LPSS)均减低(t=-5.923、-3.656、-9.377, P<0.01),梗死节段心肌LPSS较正常对应节段心肌LPSS明显减低,差异有显著统计学意义(t=-11.422、-9.957、-12.135,P<0.01)。NSTEMI亚组梗死节段心内膜LPSS与STEMI亚组比较,差异无统计学意义(t=-1.840,P> 0.05),但心外膜LPSS高于STEMI亚组,差异有显著统计学意义(t=-14.523,P<0.01)。NSTEMI亚组梗死节段心内膜LPSS低于对照组,差异有显著统计学意义(t=-13.902,P <0.01);心外膜LPSS与对照组比较,差异无统计学意义(t=-1.927,P> 0.05)。AMI组、STEMI亚组分别与对照组比较,LVEF均减低,差异有显著统计学意义(t=5.909、11.638, P<0.01);NSTEMI亚组与对照组LVEF比较,差异无统计学意义(t=1.985,P> 0.05);NSTEMI亚组与STEMI亚组LVEF比较,差异有显著统计学意义(t=6.841,P<0.01)。结论 AFI技术可以准确评估不同透壁AMI室壁节段性运动异常的特点,准确检测AMI受累范围及程度,具有广泛临床应用价值。Objective To study the characteristics of ventricular wall motion in patients with acute myocardial infarction(AMI)of different transmural degrees by automatic functional imaging(AFI), and evaluate the value in diagnosis of myocardial infarction. Methods A total of 47 patients with AMI(AMI group, which included 30 males and 17 females;aged 39-77 years old with mean age of 56.7 years old) and 50 healthy controls(control group, which included 36 males and 14 females;aged 40-75 years old with mean age of 52.1 years old) were enrolled. According to electrocaardiogram, AMI group was divided into nonST-segment elevation myocardial infarction(NSTEMI) subgroup and ST-segment elevation myocardial infarction(STEMI) subgroup.Two-dimensional gray-scale dynamic images of left ventricular apical long axis, apical four-chamber section and apical twochamber section, left ventricular apex, papillary muscle and mitral valve were obtained by echocardiography. The AFI parameters and left ventricular ejection fraction(LVEF) of 2 groups were measured by image analysis, and analyzed statistically. Results Compared with control group, the overall longitudinal peak systolic strain(LPSS) of left ventricle were significantly decreased in AMI group, NSTEMI subgroup and STEMI subgroup(t=-5.923,-3.656,-9.3-77, P < 0.01), and myocardial LPSS of infarcted segment was also significantly lower in AMI group, NSTEMI subgroup and STEMI subgroup(t=-11.422,-9.957,-12.135,P < 0.01). There was no significant difference between NSTEMI subgroup and STEMI subgroup in LPSS of infarcted segment(t =-1.840, P > 0.05), but LPSS in epicardial membrane was statistically significantly higher in NSTEMI subgroup than that in STEMI subgroup(t =-14.523, P < 0.01). The LPSS of infarcted segment in NSTEMI subgroup was significantly lower than that in control group(t=-13.902, P < 0.01). There was no significant difference in epicardial LPSS between NSTEMI subgroup and control group(t =-1.927, P > 0.05). Compared with control group, the LVEF was significantly lower in AMI

关 键 词：超声心动图 自动成像技术 心肌梗死 收缩期峰值纵向应变 

分 类 号：R540.45[医药卫生—心血管疾病] R542.2[医药卫生—内科学]