基于超声及斑点追踪技术的急性心肌梗死患者PCI术后左心房重构分析  

Analysis of Left Atrial Remodeling in AMI Patients After PCI Based on Ultrasound and Spot Tracking Technology

作　　者：秦婧[1] 张瑜 陈娟 陈小丽[3] Qin Jing;Zhang Yu;Chen Juan(Department of Cardiac Ultrasound,Affiliated Hospital of Nantong University,Nantong 226007,China;Department of Cardiac Ultrasound,The 2nd Affiliated Hospital of Nantong University,Nantong 226006,China)

机构地区：[1]南通大学附属医院心超室,南通226007 [2]南通大学第二附属医院心超室,南通226006 [3]南通大学第二附属医院心血管内科,南通226006

出　　处：《华中科技大学学报(医学版)》2024年第6期802-807,共6页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：江苏省南通市科技计划项目(No.MS22022088)。

摘　　要：目的探讨基于超声及斑点追踪技术的急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后左心房重构情况。方法选取2022年1月至2024年2月在南通大学附属医院及第二附属医院治疗的AMI患者111例作为观察组,同时选取健康体检者53例作为对照组,给予心脏超声斑点追踪成像检查,分析两组间差异,以及观察组PCI手术前后差异。结果观察组左室舒张末内径(LADd)、二维左房最大容积(2D-LAVmax)、二维左房最小容积(2D-LAVmin)、二维左房容积指数(2D-LAVI)分别为(46.45±6.34)mm、(115.32±48.16)mL、(76.32±39.39)mL、(64.04±26.36),明显高于对照组(均P<0.05),而二维左房射血分数(2D-LAEF)和二维左房扩张指数(2D-LAEI)分别为(35.09±7.52)%和(0.49±0.16),明显低于对照组(均P<0.05)。观察组心房收缩期左房平均负向应变峰值(meanSs)、心房舒张期左房平均正向应变峰值(meanSr)、左室舒张晚期左房平均负向峰值应变率(meanSRa)和左室收缩期左房平均正向峰值应变率(meanSRs)分别为(-18.28±2.23)、(12.82±4.43)、(-2.82±0.54)和(1.52±0.49),明显低于对照组(均P<0.01),而左室舒张早期左房平均负向峰值应变率(meanSRe)为(-1.14±0.36),明显高于对照组(P<0.01)。2D-LAVmax与meanSRs呈负相关(r=-0.606,P<0.05);2D-LAEF与meanSRa呈正相关(r=0.549,P<0.05)。观察组PCI术后1周、1个月左房LADd、2D-LAVmax、2D-LAVmin、2D-LAEF、2D-LAVI、2D-LAEI、meanSs、meanSr、meanSRa、meanSRs和meanSRe较术前明显改善(均P<0.05)。结论超声及斑点追踪技术可有效评估AMI患者PCI术后左心房重构。Objective To explore left atrial remodeling analysis in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI)based on ultrasound and spot tracking technology.Methods In all,111 AMI patients treated in Nantong University Affiliated Hospital and Second Affiliated Hospital from January 2022 to February 2024 were selected as the observation group,while 53 healthy individuals were selected as the control group.Ultrasound spot tracking imaging was performed,the differences between the two groups were analyzed,as well as the differences before and after PCI surgery in the observation group.Results The left ventricular end diastolic diameter(LADd),two-dimensional maximum left atrial volume(2D-LAVmax),two-dimensional minimum left atrial volume(2D-LAVmin),two-dimensional left atrial volume index(2D-LAVI)in the observation group were(46.45±6.34)mm,(115.32±48.16)mL,(76.32±39.39)mL,(64.04±26.36),which were significantly higher than that in control group(P<0.05).The two-dimensional left atrial ejection fraction(2D-LAEF)and left atrial expansion index(LAEI)were(35.09±7.52)%and(0.49±0.16),respectively,which was significantly lower than that in control group(P<0.05).The mean negative peak strain(meanSs)of the left atrium during systole,the mean positive peak strain(meanSr)of the left atrium during diastole,the mean negative peak strain rate of the left atrium during late diastole,and the mean positive peak strain rate of the left atrium during systole in the observation group were(-18.28±2.23),(12.82±4.43),(-2.82±0.54),and(1.52±0.49),respectively,which were significantly lower than those in the control group(P<0.05).The mean negative peak strain rate of the left atrium in early diastole was(-1.14±0.36),which was significantly higher than the control group(P<0.05).2D-LAVmax was negatively correlated with mean SRs(r=-0.606,P<0.05).2D-LAEF was positively correlated with meanSRa(r=0.549,P<0.05).The observation group showed significant improvement in left atrial LADd、2D-LAVmax,2D-LAVm

关 键 词：斑点追踪技术 急性心肌梗死 经皮冠状动脉介入 左心房重构 

分 类 号：R542.2[医药卫生—心血管疾病]