3D-STI在ECMO辅助下复杂冠脉病变患者PCI术前后心功能评估中的应用  

Application of 3D-STI in the Evaluation of Cardiac Function in Patients with Complex Coronary Lesions Before and After PCI Assisted by ECMO

作　　者：王凤霞[1] 陶静[1] 燕建锋 贾莉[2] 许中兴[1] 刘永国[1] 李国庆[1] WANG Fengxia;TAO Jing;YAN Jianfeng;JIA Li;XU Zhongxing;LIU Yongguo;LI Guoqing(Department of Cardiology,Xinjiang Uygur Municipan People’s Hospital,Urumq Xinjiang 830000,China;Clinical Pharmaceutical Research Institute,Xinjiang Uygur Municipan People’s Hospital,Urumq Xinjiang 830000,China)

机构地区：[1]新疆维吾尔自治区人民医院心内科,新疆乌鲁木齐830000 [2]新疆维吾尔自治区人民医院临床药研所,新疆乌鲁木齐830000

出　　处：《中国医疗设备》2021年第5期91-94,共4页China Medical Devices

基　　金：新疆维吾尔自治区人民医院院内项目(20190211)。

摘　　要：目的探讨三维斑点追踪技术(Three-Dimensional Speckle Tracking Imaging,3D-STI)在体外膜肺氧合(Extracorporeal Membrane Oxygenation,ECMO)辅助下复杂冠脉病变患者PCI术前后心功能评估中的应用价值。方法纳入新疆维吾尔自治区人民医院2018年4月1日至2020年2月29日收治的在ECMO辅助下行PCI术患者40例,记录和比较患者在不同时间节点下(术前、术后5 d、术后30 d、术后90 d)左心室整体应变情况指标(左心室舒张末容积、左心室收缩末期容量、左心室射血分数、心输出量、每搏输出量、左心室整体长轴应变值、整体圆周应变值、整体径向应变值、整体面积应变值)。结果40例患者在导管室完成PCI术后均成功ECMO脱机,均存活出院。ECMO辅助时间为(3.1±1.7)h,最初辅助流量为(2.3±0.4)L/min。经3D-STI观察左心室整体应变情况,患者经过治疗后,其LVEF、CO、SV、GLS、GCS、GRS、GAS逐渐升高,LVEDV、LVESV逐渐降低,差异均有统计学意义(均P<0.05)。结论3D-STI无创、可重复性高、操作便捷,可以对复杂冠脉病患者PCI术的心脏功能进行量化分析,为临床观察患者心脏功能恢复情况提供依据,值得在危重冠脉患者使用。Objective To explore the application value of three-dimensional speckle tracking imaging,3D-STI in the assessment of cardiac function in patients with complex coronary lesions before and after PCI assisted by extracorporeal membrane oxygenation,ECMO.Methods A total of 40 patients with PCI assisted by ECMO were enrolled in the Xinjiang Uiger Municipal People’s Hospital from April 1,2018 to February 29,2020.The left ventricular global strain indexes including LVEDV,LVESV,LVEF,Co,SV,GLS,GCS,GRS,GAS were recorded and compared at different time nodes(preoperative,postoperative 5 days,postoperative 30 days,postoperative 90 days).Results ECMO was weaned successfully in all 40 patients after PCI,and all of them survived.The auxiliary time of ECMO was(3.1±1.7)h,and the initial auxiliary flow was(2.3±0.4)L/min.After treatment,LVEF、CO、SV、GLS、GCS、GRS、GAS increased gradually,LVEDV and LVESV decreased gradually(P<0.05).Conclusion 3D-STI is non-invasive,highly repeatable and convenieny to operate.It can be used to analyze the cardiac function of PCI in patients with complex coronary artery disease,and provide basis for clinical observation of the recovery of cardiac function.

关 键 词：三维斑点追踪技术 复杂冠脉病变 心功能评估 

分 类 号：R473.6[医药卫生—护理学]