无节段性室壁运动异常冠心病患者PCI术后左室功能的效果评价  

Evaluation of left ventricular function after PCI in patients with coronary heart disease without segmental wall motion abnormalities

作　　者：薛娜[1] 刘昕[1] 李晓青[1] 屠英暄 XUE Na;LIU Xin;LI Xiao-qing;TU Ying-xuan(Department of Ultrasonography,First Central Hospital of Baoding,Baoding 071000,Hebei,China)

机构地区：[1]保定市第一中心医院超声一科、保定市超声心动图诊断重点实验室,河北保定071000

出　　处：《心脏杂志》2024年第5期516-520,共5页Chinese Heart Journal

摘　　要：目的应用常规超声心动图及三维应变定量评价无节段性室壁运动异常冠心病患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗前后左室收缩和舒张功能的变化,探讨PCI手术及支架置入数目对冠心病患者的疗效。方法选择112例无节段性室壁运动异常的冠心病患者,分别于PCI术前3 d及术后6个月行超声心动图检查,根据支架置入数目分三组,即1枚支架组(n=55)、2枚支架组(n=35)和3枚支架组(n=22),收集其基本临床资料、常规超声心动图数据及三维应变数据,并计算出相应方向的应变显像舒张功能指数(SI-DI)分析其变化。结果PCI术前术后两组数据比较,PCI术前pro-BNP数值高于术后值(P<0.05),收缩压、舒张压、血糖、血脂、体质量指数(BMI)等项目术前术后数据差异无统计学意义。PCI术前术后两组常规超声参数比较,两组间E、e′、EDV、ESV、及E/e′术后较术前升高,两组间LVEF、SV比较,术后较术前降低,但其差异均无统计学意义。PCI术前术后两组三维参数比较,PCI术前术后两组GLS、GRS、GAS、GCS、L-SI-DI、A-SI-DI、C-SI-DI、RSI-DI差异有统计学意义(均P<0.01),PCI术后明显高于术前。不同支架数3组间三维参数比较,PCI术前三组各方向应变及相应SI-DI差异无统计学意义。PCI术后随着支架数目的增加,GLS、GAS、GCS、GRS、L-SI-DI、ASI-DI、C-SI-DI及R-SI-DI呈减低趋势。2枚支架组GCS、L-SI-DI均低于1枚支架组(均P<0.05),3枚支架组GLS、GCS、GAS、L-SI-DI、C-SI-DI、A-SI-DI均低于1枚支架组(均P<0.05),3枚支架组GLS、GCS、GAS、L-SIDI、C-SI-DI低于2枚支架组(均P<0.05);三组间GRS和R-SI-DI差异无统计学意义。不同数目支架组各参数术后较术前呈升高趋势,1枚支架组GLS、GAS、GCS、GRS、L-SI-DI、A-SI-DI、C-SI-DI高于术前(均P<0.05),2枚支架组GAS高于术前(P<0.05),3枚支架组手术前后差异无统计学意义。结论三维应变优于常规超声心动图,�AIM To quantitative evaluate the changes of left ventricular systolic and diastolic function in patients with coronary heart disease without segmental abnormal ventricular wall motion before and after percutaneous coronary intervention(PCI)by conventional echocardiography and three-dimensional strain,and to investigate the efficacy of PCI and the number of stents in patients with coronary heart disease.METHODS A total of 112 patients with coronary heart disease without abnormal segmental wall motion underwent echocardiography within 3 days before PCI and 6 months after PCI were included in this study,and they were divided into three groups according to the number of stents inserted:1-stent group(n=55),2-stent group(n=35)and 3-stent group(n=22).Their basic clinical data,conventional echocardiography data and three-dimensional strain data were collected,and the corresponding direction of strain imaging diastolic index(SI-DI)was calculated to analyze its changes.RESULTS The comparison of preoperative and postoperative data between the two groups showed that the pro BNP value before PCI was higher than the postoperative value(P<0.05),and there was no statistically significant difference in preoperative and postoperative data for items such as systolic blood pressure,diastolic blood pressure,blood glucose,blood lipids,and body mass index(BMI).Comparison of routine ultrasound parameters between two groups before and after PCI showed that E,e′,EDV,ESV,and E/e′increased after surgery,while LVEF and SV decreased after surgery,but the differences were not statistically significant.Comparison of three-dimensional parameters between two groups before and after PCI showed statistically significant differences in GLS,GRS,GAS,GCS,L-SI-DI,A-SI-DI,C-SI-DI,and R-SI-DI between the two groups(all P<0.01),with significantly higher levels after PCI compared to before.There was no statistically significant difference in strain and corresponding SI-DI among the three groups before PCI,as compared to the three-dimensional parameters

关 键 词：冠心病 左室功能 实时三维斑点追踪 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]