超声左室压力-应变环评估ST段抬高型心肌梗死患者PCI术后左心收缩功能定量研究  

Quantitative study of left ventricular systolic function in patients with ST-segment elevation myocardial infarction after PCI by ultrasound left ventricular pressure-strain loops

作　　者：胡子恒 王琼[2] HU Ziheng;WANG Qiong(Department of Cardiology,Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang,Shaanxi 712000,China;Department of Cardiology,the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang,Shaanxi 712000,China)

机构地区：[1]陕西中医药大学附属医院心内科,陕西咸阳712000 [2]陕西中医药大学第二附属医院心内科,陕西咸阳712000

出　　处：《检验医学与临床》2022年第23期3235-3238,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨超声左室压力-应变环(PSL)对ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后左心收缩功能的评估价值。方法选取2019年6月至2020年12月于陕西中医药大学附属医院就诊的STEMI患者30例作为病例组,同期体检健康者30例作为对照组。分析对照组与病例组PCI术后1周、术后6个月、术后1年的动态、静态超声图像,比较两组PSL参数及整体纵向应变(GLS)参数。结果与对照组相比,病例组患者的左室射血分数(LVEF)明显降低,且在PCI术后6个月时明显改善,差异有统计学意义(P<0.05)。与PCI术前相比,病例组PCI术后6个月、术后1年患者的GLS绝对值及心肌做功参数整体做功指数(GWI)、整体有用功(GCW)、整体做功效率(GWE)明显升高,整体无用功(GWW)明显降低,差异均有统计学意义(P<0.05)。与对照组比较,病例组PCI术前及术后1周患者的GLS绝对值及心肌做功参数GWI、GCW、GWE明显降低,GWW明显升高,差异均有统计学意义(P<0.05)。相关性分析显示,GWI、GCW、GWW、GWE与LVEF、GLS绝对值的相关性均较好。结论作为一项超声新技术,PSL可无创、定量预测STEMI患者PCI术后心肌做功情况,判断左心收缩功能。Objective To investigate the value of ultrasound left ventricular pressure-strain loops(PSL)in evaluating left ventricular systolic function in patients with ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods Thirty STEMI patients treated in the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from June 2019 to December 2020 were selected as the case group,and 30 healthy controls were selected as the control group during the same period.The dynamic and static ultrasound images of the control group and the case group at 1 week,6 months and 1 year after PCI were analyzed.PSL parameters and global longitudinal strain(GLS)parameters were compared between the two groups.Results Compared with the control group,the left ventricular ejection fraction(LVEF)in the case group decreased significantly,and improved significantly at 6 months after PCI(P<0.05).Compared with preoperative PCI,absolute value of GLS and myocardial work parameters global work index(GWI),global active work index(GCW)and global work efficiency(GWE)of patients in the case group increased significantly at 6 months and 1 year after PCI,and global useless work(GWW)decreased significantly(P<0.05).Compared with the control group,absolute value of GLS and myocardial work parameters GWI,GCW and GWE decreased significantly and GWW increased significantly in the case group before PCI and 1 week after PCI(P<0.05).Correlation analysis showed that GWI,GCW,GWW,GWE were well correlated with LVEF and absolute value of GLS.Conclusion As a new ultrasound technology,PSL could noninvasively and quantitatively predict the myocardial work of patients with STEMI after PCI,and determine left ventricular systolic function.

关 键 词：左室压力-应变环 ST段抬高型心肌梗死 心肌做功 经皮冠状动脉介入治疗 

分 类 号：R542.22[医药卫生—心血管疾病]