三维斑点追踪显像对冠心病患者左室运动功能评价效果的研究  

Evaluation effects of three-dimensional speckle tracking imaging on left ventricular function in patients with coronary heart disease

作　　者：周洁舲 孙书菊 Zhou Jieling;Sun Shuju(Function Department,Yafeiya Maternity Hospital,Enshi 445099,China;Department of Ultrasound Imaging,Minda Hospital of Hubei Minzu University,Enshi 445099,China)

机构地区：[1]亚菲亚妇产医院功能科,恩施445099 [2]湖北民族大学附属民大医院超声影像科,恩施445099

出　　处：《中国心血管杂志》2020年第5期442-446,共5页Chinese Journal of Cardiovascular Medicine

摘　　要：目的研究三维斑点追踪显像(3D-STI)技术对冠心病(CHD)患者左室运功功能的评估价值。方法选取2017年6月至2018年6月湖北民族大学附属民大医院确诊的CHD患者127例,均完成冠状动脉造影并行Gensini评分,按其积分将患者分为轻度组和重度组,另选取年龄、性别类似的同期健康体检者50例为对照组,超声心动图取3组受检者心尖两腔和左室基底段、中间段、心尖段短轴位图像并进行分析,比较3组心功能、左室扭转运动及应变指标。结果3组的年龄、性别、体质指数及既往病史等基本资料比较差异无统计学意义(均为P>0.05)。对照组、轻度组和重度组的左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)逐渐升高,左室射血分数(LVEF)和左室三维峰值位移(P3DD)逐渐降低,且各组差异有统计学意义(均为P<0.05);重度组的整体扭转角度峰值(PGT)、基底段扭转角度峰值(PBT)、中间段扭转角度峰值(PMT)和心尖段扭转角度峰值(PAT)均低于对照组,且PBT、PMT和PAT低于轻度组,轻度组PMT和PAT低于对照组,差异均有统计学意义(均为P<0.05);此外,对照组、轻度组和重度组的3D整体面积应变(GAS)、3D整体纵向应变(GLS)、3D整体径向应变(GRS)和3D整体圆周应变(GCS)逐渐降低,且各组差异均有统计学意义(均为P<0.05)。经Pearson相关系数分析显示GAS、GLS、GRS和GCS与P3DD、LVEF、PMT及PAT均呈显著正相关性(均为P<0.05)。结论3D-STI技术可用于准确测量CHD患者左室整体及各节段扭转运动状态和心肌应变参数变化,为评价心功能和CHD病情进展提供参考依据,且无须注射造影剂等有创性操作,具有良好效果和安全性。Objective To study the evaluated value of three-dimensional speckle tracking imaging(3D-STI)for left ventricular function in patients with coronary heart disease(CHD).Methods A total of 127 cases of patients with CHD diagnosed in Minda Hospital of Hubei Minzu University were selected from June 2017 to June 2018,all completed coronary angiography and Gensini score.The patients were divided into mild group and severe group according to the score,and another 50 healthy subjects with physical examination during the same time period were selected as control group.GE vivid E9 Doppler ultrasound diagnostic apparatus and the supporting 4V probe were used to obtain and analyze the short-axis images of the apical two-chamber and the left ventricular basal,middle and apical segments of the three groups of subjects,and the cardiac function and left ventricular torsion and strain index were compared among the three groups.Results There were no significant differences in the basic data such as age,gender,body mass index and previous medical history among the three groups(all P>0.05).The left ventricular end diastolic volume(LVEDV)and left ventricular end systolic volume(LVESV)were gradually increased while the left ventricular ejection fraction(LVEF)and left ventricular three-dimensional peak displacement(P3DD)were gradually decreased in control group,mild group and severe group(all P<0.05).The peak overall torsion angle(PGT),peak basal torsion angle(PBT),peak mid-segment torsion angle(PMT)and apical torsion angle(PAT)in severe group were lower than those in control group,and the PBT,PMT and PAT were lower than those in mild group,and the PMT and PAT in mild group were lower than those in control group(all P<0.05).The 3D global area strain(GAS),3D global longitudinal strain(GLS),3D global radial strain(GRS)and 3D global circumferential strain(GCS)in control group,mild group and severe group were gradually decreased(all P<0.05).Pearson correlation coefficient analysis showed that the GAS,GLS,GRS and GCS were positively correlat

关 键 词：冠状动脉疾病 三维斑点追踪显像技术 左室扭转运动 心肌应变 射血分数 

分 类 号：R54[医药卫生—心血管疾病]