2D-STE在评价急性心肌梗死后存活心肌及左室整体收缩功能中的价值  

The value of 2D-STE in evaluating myocardial viability and left ventricular global systolic function after acute myocardial infarction

作　　者：王蕾[1] 柯剑林 赵可辉[1] 赵传珂 WANG Lei;KE Jianlin;ZHAO Kehui;ZHAO Chuanke(The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine Special Inspection Section,Jinan 250001, P.R.China)

机构地区：[1]山东中医药大学第二附属医院特检科,山东济南250001

出　　处：《医学影像学杂志》2020年第12期2198-2202,共5页Journal of Medical Imaging

摘　　要：目的探讨二维斑点追踪超声心动图(two-dimensional spot tracking echocardiography,2D-STE)在评价急性心肌梗死(acute myocardial infarction,AMI)后存活心肌及左室整体收缩功能中的价值。方法分析本院收治的110例初发AMI患者的病历资料(观察组),另选取同期在本院进行体检的110例健康人群作为对照组。分析观察组患者存活心肌和非存活心肌节段,比较环周应变(CS)、以及纵向应变(LS),左心室的整体纵向应变(GLS)、圆周应变(GCS)、左室扭转角度(LVtw)。结果术前心脏彩超检查结果显示,110例AMI患者共616个运动异常节段,其中PCI前运动减低、无运动、反常运动分别有532、66、18个节段;随访分析显示,存活心肌节段429个、非存活心肌节段187个。存活心肌节段CS、LS的绝对值明显高于非存活心肌节段,差异均有统计学意义(P<0.05)。ROC曲线评价AMI存活心肌的敏感度为97.2%,特异度为90.6%。观察组与对照组GCS、GLS、LVtw水平比较,差异均有统计学意义(均P<0.05)。ROC曲线评价AMI左室整体收缩功能的敏感度为100%,特异度为100%。结论2D-STE在评价AMI后存活心肌及左室整体收缩功能中的价值较高,值得在临床上使用。Objective To explore the value of 2D-STE in evaluating myocardial viability and left ventricular global systolic function after AMI.Methods The medical records of 110 patients with primary AMI admitted to our hospital(observation group)were analyzed retrospectively.In addition,110 healthy people who had physical examination in our hospital in the same period were selected as the control group.The segments of viable and non viable myocardium in the observation group were analyzed,and CS,LS,GLS,GCS and LVtw were compared.Results The results of color Doppler echocardiography showed that there were 616 abnormal motion segments in 110 AMI patients,including 532,66 and 18 segments of decreased,no and abnormal motion before PCI;the follow-up analysis showed that there were 429 viable and 187 non viable segments.The absolute values of CS and LS in the viable segments were significantly higher than those in the non viable segments(P<0.05).The sensitivity and specificity of ROC curve were 97.2%and 90.6%respectively.There were significant differences in GCS,GLS and LVtw between the two groups(P<0.05).The sensitivity and specificity of ROC curve in evaluating left ventricular global systolic function were 100%and 100%,respectively.Conclusion 2D-STE has a high value in evaluating myocardial viability and left ventricular global systolic function after acute myocardial infarction,which is worthy of clinical use.

关 键 词：二维斑点追踪超声心动图 急性心肌梗死 存活心肌 左室整体收缩功能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541[医药卫生—诊断学]