斑点追踪超声心动图指标与冠心病心肌纤维化程度的关系  

Relationship between speckle tracking echocardiographic indicators and myocardial fibrosis degree in coronary heart disease

作　　者：张玉莲 邓玮[2] 周勇君 王云会 付汝倩 韦余 ZHANG Yulian;DENG Wei;ZHOU Yongjun;WANG Yunhui;FU Ruqian;WEI Yu(Department of General Medicine,Banan Hospital of Chongqing Medical University,Chongqing401320,China;Department of General Medicine,the Second Affiliated Hospital of Chongqing Medical University,Chongqing400010,China;Department of General Surgery,Chongqing Banan Hospital of Traditional Chinese Medicine,Chongqing401320,China)

机构地区：[1]重庆医科大学附属巴南医院全科医学科,重庆401320 [2]重庆医科大学附属第二医院全科医学科,重庆400010 [3]重庆市巴南区中医院普外科,重庆401320

出　　处：《中国医药导报》2024年第19期145-149,共5页China Medical Herald

基　　金：重庆市科卫联合医学科研项目(2021MSXM094)。

摘　　要：目的探索斑点追踪超声心动图(STE)指标与冠心病心肌纤维化(MF)程度的关系。方法选择重庆医科大学附属第二医院全科医学科2019年9月至2020年9月56例冠心病患者,所有患者均接受心脏磁共振延迟钆增强(CMR-LGE)和STE检查。根据CMR-LGE测定的阳性节段数分为无纤维化组(16例)、轻度纤维化组(23例)和重度纤维化组(17例)。比较三组左室收缩期内径、左室舒张期内径、室间隔厚度、左室射血分数(LVEF)、整体纵向应变(GLS)、应变达峰时间、左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV),左室质量指数(LVMI);分析STE指标与MF程度的相关性。结果三组左室舒张期内径、左室收缩期内径、室间隔厚度、LVEF、LVEDV、LVESV、LVMI比较,差异无统计学意义(P>0.05);三组GLS、应变达峰时间比较,差异有统计学意义(P<0.05)。重度纤维化组GLS低于轻度纤维化组及无纤维化组,应变达峰时间长于轻度纤维化组及无纤维化组;轻度纤维化组GLS低于无纤维化组,应变达峰时间长于无纤维化组(P<0.05)。GLS与MF程度呈负相关(r=-0.709,P<0.01),应变达峰时间与MF程度呈正相关(r=0.778,P<0.01)。结论STE能评估冠心病患者MF情况,GLS、应变达峰时间与MF相关,可作为临床评估缺血性MF的一种可靠方法。Objective To explore the relationship between speckle tracking echocardiography(STE)indicators and myocardial fibrosis(MF)degree in coronary artery disease.Methods A total of 56 patients with coronary heart disease in the Department of General Medicine,the Second Affiliated Hospital of Chongqing Medical University from September 2019 to September 2020 were selected,all patients underwent cardiovascular magnetic resonance-late gadolinium enhancement(CMR-LGE)and STE.According to the number of positive segments measured by CMR-LGE,they were divided into non-fibrosis group(16 cases),mild fibrosis group(23 cases),and severe fibrosis group(17 cases).Left ventricular systolic diameter,left ventricular diastolic diameter,ventricular septal thickness,left ventricular ejection fraction(LVEF),global longitudinal strain(GLS),peak time of strain,left ventricular end systolic volume(LVESV),left ventricular end diastolic volume(LVEDV),and left ventricular mass index(LVMI)were compared among three groups;the correlation between STE indicators and MF degree was analyzed.Results There were no significant differences in left ventricular diastolic diameter,left ventricular systolic diameter,ventricular septal thickness,LVEF,LVEDV,LVESV,and LVMI among three groups(P>0.05);while there were significant differences in GLS and peak time of strain among three groups(P<0.05).GLS in severe fibrosis group was lower than that in mild fibrosis group and non-fibrosis group,and peak time of strain was longer than that in mild fibrosis group and non-fibrosis group;GLS in mild fibrosis group was lower than that in non-fibrosis group,and peak time of strain was longer than that in non-fibrosis group(P<0.05).GLS was negatively correlated with MF degree(r=-0.709,P<0.01),and peak time of strain was positively correlated with MF degree(r=0.778,P<0.01).Conclusion STE can evaluate MF in patients with coronary heart disease,GLS and peak time of strain are related to MF,and it can be used as a reliable method for clinical evaluation of ischemic MF.

关 键 词：心肌纤维化 冠心病 斑点追踪超声心动图 整体纵向应变 应变达峰时间 

分 类 号：R542.2[医药卫生—心血管疾病]