二维超声斑点追踪成像技术评价冠心病患者冠脉旁路移植术后心肌功能的临床价值  

Clinical value of speckle tracking imaging technique in evaluating myocardial function after coronary artery bypass transplantation in patients with coronary heart disease

作　　者：沈嘉祺 王玉玖[2] 卞斐 丁立群 王傲 邹明锐 刘宝辉[2] SHEN Jiaqi;WANG Yujiu;BIAN Fei;DING Liqun;WANG Ao;ZOU Mingrui;LIU Baohui(First Clinical College of Medicine,Binzhou Medical University,Binzhou 256603,Shandong,P.R.China;Department of Cardiac Surgery,Binzhou Medical University Hospital,Binzhou 256603,Shandong,P.R.China)

机构地区：[1]滨州医学院第一临床医学院,山东滨州256603 [2]滨州医学院附属医院心外科,山东滨州256603

出　　处：《滨州医学院学报》2023年第3期171-175,共5页Journal of Binzhou Medical University

基　　金：山东省医药卫生科技发展计划(2019WS327)。

摘　　要：目的探讨二维超声斑点追踪成像技术定量评价冠状动脉旁路移植术(CABG)患者术前、术后心肌功能的临床价值。方法将拟行CABG的冠状动脉粥样硬化性心脏病(CHD)患者32例作为研究人群分为两组,60岁以上为老年组18例,60岁以下为中年组14例。同时,随机选择20例门诊健康体检者作为对照组。全部患者分别于术前1周及术后1、3、6月行常规超声心动图检查,然后应用二维斑点追踪技术进行分析,通过检测心脏左心室室壁各节段的纵向应变值分析超声心动图一般参数和心肌应变测量值,以比较各组患者心脏左心室局部及整体心肌收缩功能相关指标的变化。结果对照组与两亚组术前基线资料、超声心动图常规参数差异均无统计学意义。与对照组比较,CHD患者CABG术前及术后心脏运动纵向应变值比较均有差异显著(P<0.05)。在CABG各组患者中,与术前比较,CHD患者术后1月心脏运动纵向应变值均差异不显著;患者术后3、6月心脏运动纵向应变值均显著增高(P<0.05)。仅老年组术后6月心脏运动纵向应变值与术后3月比较显著增高(P<0.05)。结论斑点追踪技术可以定量评价CHD患者CABG治疗前后心肌收缩功能,辅助评价治疗效果及预后。Objective To investigate the clinical value of speckle tracking imaging(STI)in quantitative evaluation of myocardial function before and after coronary artery bypass grafting(CABG).Methods Thirty-two patients with coronary heart disease(CHD)who underwent CABG were selected,and they were divided into the elderly group and the middle-aged group.At the same time,20 healthy subjects were selected.All patients underwent routine echocardiography 1 week before surgery and 1 month,3 months and 6 months after surgery.Echocardiographic parameters and myocardial strain measurements were analyzed,and the changes of cardiac function related indicators before and after surgery were compared.Results There was no significant difference in preoperative baseline data and routine echocardiographic parameters between the control group and the two subgroups.Compared with those in the control group,the longitudinal strain values of cardiac exercise of CABG before and after surgery were significantly different(P<0.05).There was no significant difference in the longitudinal strain values of cardiac exercise 1 month after surgery in all groups of CABG patients compared with those before surgery.Longitudinal strain values of cardiac exercise were significantly increased 3 months and 6 months after surgery(P<0.05).Only the longitudinal strain value of cardiac exercise in the aged group was significantly increased 6 months after surgery compared with 3 months after surgery(P<0.05).Conclusion Speckle tracking imaging can be used to quantitatively evaluate myocardial systolic function in patients with coronary heart disease before and after coronary artery bypass grafting,which is of important clinical value in evaluating the therapeutic effect and prognosis.

关 键 词：冠状动脉旁路移植术 冠心病 超声心动图 斑点追踪技术 

分 类 号：R654.2[医药卫生—外科学]