4D-STI技术应变参数联合RTMCE检测心肌血流量对急性心肌梗死心肌存活的预测价值  

The predictive value of 4D-STI technique strain parameters combined with RTMCE in detecting myocardial blood flow for myocardial survival in acute myocardial infarction

作　　者：宁伟[1] 邸海燕[1] 李娅 锅红芬 蒲红生 NING Wei;DI Haiyan;LI Ya;GUO Hongfen;PU Hong-sheng(Color Doppler Ultrasound Room,Baoding Second Central Hospital,Baoding Hebei 072750,China)

机构地区：[1]保定市第二中心医院彩超室,河北保定072750 [2]保定市第二中心医院病理科,河北保定072750 [3]无极县妇幼保健院彩超室,河北石家庄052460

出　　处：《中国急救复苏与灾害医学杂志》2021年第11期1244-1248,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：2017年河北省医学科学研究课题计划(编号:20171767)。

摘　　要：目的探讨四维斑点追踪超声显像(4D-STI)技术应变参数联合实时心肌超声造影(RTMCE)检测心肌血流量对急性心肌梗死(AMI)心肌存活的预测价值。方法选取保定市第二中心医院2018年1月—2020年4月AMI患者103例作为研究对象,均行经皮冠状动脉介入(PCI)术治疗,根据术后3个月心肌存活情况分为心肌存活组(n=80)与心肌失活组(n=23)。比较两组4D-STI技术应变参数[左室整体纵向应变(LS)、环周应变(CS)、径向应变(RS)、面积应变(AS)]、心肌血流量(MBF),采用Pearson进行相关性分析,采用多元线性回归分析心肌存活的相关影响因素,采用受试者工作特征曲线(ROC)及ROC下面积(AUC)分析LS、CS、RS、AS、MBF对心肌存活的预测价值。结果心肌存活组LS、CS、RS、AS、MBF高于心肌失活组(P<0.05);LS、CS、RS、AS与MBF呈正相关(P<0.05);LS、CS、RS、AS、MBF与左心室射血分数(LVEF)呈正相关,与左心室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)呈负相关,与心肌存活显著相关(P<0.05);术前LS、CS、RS、AS、MBF联合预测心肌存活的AUC为0.896,敏感度为77.50%,特异度为91.30%。结论LS、CS、RS、AS与MBF具有相关性,二者联合对AMI患者心肌活性具有一定预测价值,可指导临床及时开展针对性治疗措施,以预防心肌失活发生。Objective To investigate the predictive value of four-dimensional speckle tracking imaging(4D-STI)technique strain parameters combined with real-time myocardial contrast echocardiography(RTMCE)in detecting myocardial blood flow for myocardial survival in acute myocardial infarction(AMI).Methods From January 2018 to April 2020,103 patients with AMI in our hospital were selected as the research objects,all of whom were treated with percutaneous coronary intervention(PCI).According to the myocardial survival at 3 months after operation,they were divided into myocardial survival group(n=80)and myocardial inactivation group(n=23).The 4D-STI technique strain parameters[left ventricular global longitudinal strain(LS),circumferential strain(CS),radial strain(RS),area strain(AS)],myocardial blood flow(MBF)of the two groups were compared.Pearson was used for correlation analysis,and multiple linear regression was used to analyze related factors affecting myocardial survival.Receiver operating characteristic curve(ROC)and area under ROC(AUC)were used to analyze the predictive value of LS,CS,RS,AS,MBF for myocardial survival.Results LS,CS,RS,AS,MBF in the myocardial survival group were higher than those in the myocardial inactivation group(P<0.05).LS,CS,RS,AS and MBF were positively correlated(P<0.05).LS,CS,RS,AS,MBF were positively correlated with left ventricular ejection fraction(LVEF),negatively correlated with left ventricular end systolic volume(LVESV),left ventricular end diastolic volume(LVEDV),and significantly correlated with myocardial survival(P<0.05).The AUC of preoperative LS,CS,RS,AS and MBF combined prediction of myocardial survival was 0.896,the sensitivity was 77.50%and specificity was 91.30%.Conclusion There is a correlation between LS,CS,RS,AS and MBF.The combination of the two has a certain predictive value for myocardial activity in patients with AMI,and can guide the clinic to carry out targeted treatment measures in time to prevent myocardial inactivation.

关 键 词：急性心肌梗死 心肌超声造影 四维斑点追踪超声显像 实时心肌超声造影 心肌存活 心肌血流量 相关性 

分 类 号：R445.1[医药卫生—影像医学与核医学]