无创心肌做功超声成像联合血清标志物评估冠心病PCI手术前后心功能的差异性研究  

Difference of cardiac functionof coronary heart disease patients before and after PCI by non-invasive ultrasonic myocardial work imaging technology and serum marker detection

作　　者：刘辉 张楠 张惠敏 王南 包迪 高曼丽 周琦 蔡芹芹 LIU Hui;ZHANG Nan;ZHANG Huimin;WANG Nan;BAO Di;GAO Manli;ZHOU Qi;CAI Qinqin(Department of Ultrasound, Suqian First Hospital, Suqian 223800, China)

机构地区：[1]江苏省宿迁市第一人民医院超声医学科,江苏宿迁223800

出　　处：《医学影像学杂志》2022年第7期1139-1143,共5页Journal of Medical Imaging

基　　金：江苏省宿迁市科学技术局科技计划项目(编号:S202114)。

摘　　要：目的探讨无创心肌做功超声成像技术联合血清标志评估冠心病经皮冠状动脉介入(PCI)手术前、后心脏功能的差异性。方法选取我院PCI患者160例为冠心病组,另选同期80例健康体检者为健康组。对受检者进行常规超声心动图、无创心肌做功,检测成纤维细胞生长因子21(FGF-21)、血管内皮生长因子(VEGF),分析冠心病患者PCI术前、后无创心肌做功参数与血清FGF-21、VEGF水平。结果冠心病组LVEF低于健康组(P<0.05),LVEDD、LVESD、LVEDV、LVESV均高于健康组(P<0.05)。冠心病组GCW、GWI、GWE低于健康组(P<0.05),GWW、GLS高于健康组(P<0.05)。冠心病组血清FGF-21、VEGF水平高于健康组(P<0.05)。与术前比较,术后1个月的无创心肌做功无明显变化(P>0.05);术后3个月的LVEF、GCW、GWI、GWE增加,GWW、GLS下降(P<0.05)。与术前比较,术后1个月患者血清FGF-21水平下降,VEGF水平上升(P<0.05);术后3个月,患者血清FGF-21、VEGF水平下降(P<0.05),且FGF-21水平低于术前(P<0.05),VEGF水平与术前差异无统计学意义(P>0.05)。结论无创心肌做功超声成像可有效评估冠心病患者PCI术前、后左心室收缩功能,血清FGF-21、VEGF为敏感血清标志物,两者联合能动态评估患者心脏功能。Objective To analyze the difference of cardiac functionof coronary heart disease(CHD)patients before and after percutaneous coronary intervention(PCI)through non-invasive ultrasonic myocardial work imaging technology and serum marker detection.Methods 160 CHD patients receiving PCI in our hospital and another 80 healthy controls were recruited.Routine ultrasonic cardiogram,ultrasonic myocardial work imaging,examinations of serum fibroblast growth factor 21(FGF-21)and vascular endothelial growth factor(VEGF)were carried out among all individuals.Subsequently,the non-invasive myocardial work indexes,serum FGF-21 and VEGF were studied in CHD patients before and after PCI.Results Compared with healthy group,the left ventricular ejection fraction(LVEF)value was significantly lower inCHD group(P<0.05),and the values of left ventricular end diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic volume(LVEDV)and left ventricular end-systolic volume(LVESV)were significantly higher in CHD group,with statistical difference(all P<0.05).The values of global constructive work(GCW),global work index(GWI),and global work efficiency(GWE)were significantly lower in CHD group than in healthy group(P<0.05),and the values of global work waste(GWW)and global longitudinal strain(GLS)were significantly higher in CHD group than in healthy group(P<0.05).Serum levels of FGF-21 and VEGF of CHD group were significantly higher compared with healthy group(P<0.05).The non-invasive myocardial work indexes at postoperative 1 month yielded no statistical difference compared with those at baseline(P>0.05).Values of LVEF,GSW,GWI and GWE were increased,and values of GWW and GLS were decreased at postoperative 3 months(P<0.05).A decrease in FGF-21 and an increase in VEGF level were observed at postoperative 1 month compared with those at baseline data(P<0.05).A decrease in serum FGF-21 and VEGF was observed at postoperative 3 months(P<0.05).Compared with bas-eline data,FGF-21 level was significantly decr

关 键 词：冠心病 经皮冠状动脉介入术 无创心肌做功 超声成像 血清标志物 

分 类 号：R541.4[医药卫生—心血管疾病] R445.1[医药卫生—内科学]