应用VVI技术分析炙甘草汤对心肌应变的作用  

Application of VVI technique in evaluation of Application of Roasted Licorice Decoction on myocardial strain

作　　者：王琳[1] 王湘竹 贺海东[1] 杨阳 康杰[1] WANG Lin;WANG Xiangzhu;HE Haidong;YANG Yang;KANG Jie(Department of Ultrasound,Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700,China;Department of Ultrasound,Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100000,China;Department of Cardiology,Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100000,China)

机构地区：[1]北京中医药大学东直门医院超声科,100700 [2]北京中医药大学第三附属医院超声科,100000 [3]北京中医药大学第三附属医院心内科,100000

出　　处：《重庆医学》2021年第9期1494-1497,1503,共5页Chongqing medicine

基　　金：北京中医药大学校级课题青年教师项目(2018-JYBZZ-JS083)。

摘　　要：目的探讨炙甘草汤加减方对伴有冠心病的心律失常患者心肌收缩功能的影响。方法将65例伴冠心病的心律失常患者根据其心电图及平板试验病变导联分为A、B、C 3组,A组为Ⅱ、Ⅲ、aVF的ST-T改变(n=21),B组为Ⅰ和AVL的ST-T改变(n=24),C组为V1~V6的ST-T改变(n=20)。在应用炙甘草汤加减方治疗前后,采用超声心动图及速度向量成像技术(VVI)对各组患者进行心脏射血分数及四腔心切面6个节段心肌应变分析。结果与治疗前比较,3组患者治疗后的左心室射血分数(LVEF)未见明显改变(P>0.05)。A组患者治疗前后在室间隔的基底段比较差异有统计学意义(P<0.05),其余节段心肌纵向应变的结果比较差异无统计学意义(P>0.05);B组患者的心肌6个节段在治疗前后的纵向应变比较,差异均无统计学意义(P>0.05);C组患者治疗前后除室间隔的心尖段比较差异有统计学意义(P<0.05),其余5个节段治疗前后比较差异无统计学意义(P>0.05)。结论炙甘草汤加减方对缺血节段心肌的心肌收缩功能有明显的改善作用,VVI应用于微观及节段性评估心肌功能较传统心功能检查具有明显的优势。Objective To explore the effect of additional and subtractive prescriptions of Roasted Licorice Decoction on the myocardial contractile functions in the patients with arrhythmia complicating coronary artery heart diseases.Methods Sixty-five patients with arrhythmias complcatng coronary heart disease were divided into three groups:group A,B and C according to their electrocardiogram and the leson lead of plate test.The group A had the changes of ST-T inⅡ,Ⅲand aVF(n=21),group B had the changes of ST-T inⅠand AVL(n=24),and group C had the changes of ST-T in V1-V6(n=20).Before and after the treatment with Zhiglycyrrhiza decoction,echocardiography and velocity vector imaging(VVI)were used to analyze the cardiac ejection fraction and the myocardial strain at six segments in the four-chamber view.Results There was no significant change in left ventricular ejection fraction(LVEF)after treatment in 3 groups compared with before treatment(P<0.05).There was statistically significant difference in the basal segment of ventricular septum in the group A between before and after treatment(P<0.05),but no statistically significant difference was found in the longitudinal strain resuts of myocardial in other segments(P>0.05).There was no statstcally significant difference in the longitudinal strain of six myocardial segments in the the group B between before and after treatment(P>0.05).In the group C,there was statistically significant difference before and after treatment except for the apical segment of ventricular septum(P<0.05),while there was no statistically significant difference in the other five segments between before and after treatment(P>0.05).Conclusion Additional and subtractive prescriptions of Roasted Licorice Decoction has an evident role in improvingthe functions of myocardial contraction in myocardial ischemic segments,and the application of VVI has the obvious advantages in evaluating the microscopic and segmental myocardial function compared with the traditional cardiac function examnation.

关 键 词：速度向量成像技术 炙甘草汤 心肌应变 心律失常 冠心病 

分 类 号：R540[医药卫生—心血管疾病]