速度向量成像技术检测冠心病患者左心室心肌应变参数及其在PCI术后非犯罪血管病变进展评估中的应用  

Application of Velocity Vector Imaging in Detecting Left Ventricular Myocardial Strain Parameters and Evaluating Non-Criminal Vascular Lesion Progression after PCI in Patients with Coronary Heart Disease

作　　者：范智媛 鲁瑛 杜鸿瑶 潘晔 韩佳 FAN Zhi-yuan;LU Ying;DU Hong-yao;PAN Ye;HAN Jia(Department of Ultrasound,Tangshan Hospital of Traditional Chinese Medicine,Tangshan 063000,China;Department of Radiology,Tangshan Hospital of Traditional Chinese Medicine,Tangshan 063000,China;the Third Department of Cardiovascular Medicine,Tangshan Hospital of Traditional Chinese Medicine,Tangshan 063000,China)

机构地区：[1]唐山市中医医院超声科,河北唐山063000 [2]唐山市中医医院放射科,河北唐山063000 [3]唐山市中医医院心血管三科,河北唐山063000

出　　处：《南昌大学学报（医学版）》2023年第4期59-64,共6页Journal of Nanchang University：Medical Sciences

基　　金：河北省中医药科研课题项目(2022548)。

摘　　要：目的探究速度向量成像(VVI)技术检测冠心病患者左心室心肌应变参数并评估其在经皮冠状动脉介入治疗(PCI)术后非犯罪血管病变(NCCLs)进展中的应用价值。方法选取2020年7月至2022年6月唐山市中医医院PCI术后冠心病患者150例,分析其NCCLs进展情况,依据是否进展分为2组:进展组和未进展组。VVI技术检测左心室心肌应变参数[径向应变(GRS)、圆周应变(GCS)、纵向应变(GLS)]并比较2组心肌应变参数;单因素和Logistic多因素分析NCCLs进展的影响因素;比较不同NCCLs进展程度患者的心肌应变参数,分析心肌应变参数与NCCLs进展影响因素、程度的相关性;受试者工作特征曲线分析心肌应变参数评估NCCLs进展的价值。结果NCCLs进展率为34.67%;与未进展组比较,进展组GRS更低,而GCS、GLS更高(均P<0.05);年龄、糖尿病、左室射血分数(LVEF)、病变支数均为冠心病患者PCI术后NCCLs进展的影响因素;GRS与冠心病患者病变支数呈负相关(r=-0.409,P<0.05),与LVEF呈正相关(r=0.431,P<0.05),GCS、GLS与病变支数呈正相关(r=0.393、0.413,均P<0.05),与LVEF呈负相关(r=-0.422、-0.452,均P<0.05);NCCLs进展重度患者GRS低于中度和轻度患者,中度患者GRS低于轻度患者,而重度患者GCS、GLS高于中度和轻度患者,中度患者GCS、GLS高于轻度患者(均P<0.05);GRS与NCCLs进展程度呈负相关(r=-0.561,P<0.05),GCS、GLS与NCCLs进展程度呈正相关(r=0.425、0.521,均P<0.05);GRS、GCS、GLS评估NCCLs进展的曲线下面积(AUC)均大于0.7,联合评估的AUC最大,为0.912。结论VVI技术可准确测量冠心病患者左心室心肌应变参数,且心肌应变参数可较好地评估PCI术后NCCLs进展。Objective To explore the value of velocity vector imaging(VVI)in detecting left ventricular myocardial strain parameters and evaluating the progression of non-criminal vascular lesions(NCCLs)after percutaneous coronary intervention(PCI)in patients with coronary heart disease.Methods According to the progression of NCCLs,150 patients with coronary artery disease who underwent PCI in Tangshan Hospital of Traditional Chinese Medicine from July 2020 to June 2022 were divided into two groups:progression group and non-progression group.The left ventricular myocardial strain parameters[global radial strain(GRS),global circumferential strain(GCS)and global longitudinal strain(GLS)]were detected by VVI,and were compared between the two groups.The factors influencing the progression of NCCLs were analyzed by univariate and multivariate analysis.Furthermore,the relationships of myocardial strain parameters to the influencing factors and the degree of NCCLs progression were analyzed.The value of myocardial strain parameters in assessing NCCLs progression was evaluated using the receiver operating characteristic(ROC)curves.Results The progression rate of NCCLs was 34.67%.Compared with the non-progression group,GRS decreased but GCS and GLS increased in the progression group(P<0.05).Age,diabetes mellitus,left ventricular ejection fraction(LVEF)and number of involved vessels were the factors influencing the progression of NCCLs in patients with coronary heart disease after PCI.The GRS was negatively correlated with the number of involved vessels(r=-0.409,P<0.05),but positively related to LVEF(r=0.431,P<0.05).Both GCS and GLS were positively correlated with the number of involved vessels(r=0.393、0.413,both P<0.05),but negatively associated with LVEF(r=-0.422、-0.452,both P<0.05).The GRS in patients with severe NCCLs was lower than that in those with moderate or mild NCCLs,and that in those with moderate NCCLs was lower than that in those with mild NCCLs(P<0.05).The GCS and GLS in patients with severe NCCLs were higher than th

关 键 词：速度向量成像 冠心病 左心室心肌应变 非犯罪血管病变 价值评估 

分 类 号：R541.4[医药卫生—心血管疾病]