目的：应用二维斑点追踪显像技术（2D-STI）评价冠状动脉慢血流（SCF）患者左心室整体及局部收缩及舒张功能。方法：40例SCF患者均行超声检查，应用常规超声心动图测量左心室收缩末期内径（LVDS）、左心室舒张末期内径（LVDD），根据Simpson公式原理计算左心室收缩末期容积（LVESV）、舒张末期容积（LVEDV）、射血分数（LVEF）。测量二尖瓣血流舒张早期峰值流速（E）和舒张晚期峰值流速（A），并计算E/A比值。应用2D-STI测量应变参数：收缩期左心室的纵向峰值应变（LS）并计算平均值作为左心室整体纵向收缩峰值应变（GLS）、达峰时间（TPSLS）；左心室各节段心肌的纵向、径向、圆周应变峰值（LSpeak、RSpeak、CSpeak）及达峰时间（TPSLS、TPSRS、TPSCS）；舒张早期纵向峰值应变率（SRe）、舒张晚期纵向峰值应变率（SRa）及应变显像舒张指数（SI-DI）。获得左心室整体及各节段应变曲线。另选冠状动脉造影正常的40例患者作为对照组，进行比较分析。结果：左心室整体纵向应变指标的比较：病例组患者心肌的GLS较对照组有不同程度降低，TPSLS延迟，差异有统计学意义（P<0.05）。病例组患者局部心肌应变指标的比较：SCF节段与非SCF节段相比，SCF节段的LSpeak、RSpeak、CSpeak减低，TPSLS、TPSRS、TPSCS延迟，差异均有统计学意义（P<0.05）。慢血流节段心肌SRe、SRa、SI-DI有不同程度降低，差异均有统计学意义（P<0.05）。结论：2D-STI可以评价SCF患者左心室整体及局部收缩及舒张功能。
Abstract
Objective: To evaluate the left ventricular global and regional systolic and diastolic function in patients with slow coronary flow(SCF) by two-dimensional speckle tracking image(2D-STI). Methods: Forty patients with slow coronary flow underwent echocardiography, 40 persons with normal coronary angiography were selected as control group. The left ventricular end systolic diameter(LVDS), left ventricular end diastolic diameter(LVDD), left ventricular end systolic volume(LVESV), left ventricular end diastolic volume(LVEDV), left ventricular ejection fraction(LVEF) were measured by two-dimensional echocardiography and apical biplane Simpson’s method. The A and E peak flow velocity of mitral valve and E/A were obtained by pulsed-wave Doppler. The longitudinal peak strain(LSpeak), global longitudinal strain(GLS), TPSLS. Longitudinal, radial, circumferential strain peaks(LSpeak, RSpeak, CSpeak), and the time to peak strain (TPSLS, TPSRS, TPSCS), early diastolic peak strain rate(SRe)， late diastolic peak strain rate(SRa) and train imaging diastolic index(SI-DI) and the strain curve of global and each segment were obtained by 2D-STI. These data were compared between groups. Results: The GLS of left ventricular in SCF group was decreased in different degrees and TPSLS was delayed compared with control group, the difference was statistically significant(P<0.05). The LSpeak, RSpeak, CSpeak in SCF segments were decreased and TPSLS, TPSRS, TPSCS were delayed compared with non-SCF segments, the difference was statistically significant(P<0.05). SRe, SRa and SI-DI were decreased in different degrees in slow coronary flow segments, the difference was statistically significant(P<0.05). Conclusion: 2D-STI can assess left ventricular global and regional systolic and diastolic function in patients with SCF.
关键词
心室功能 /
左 /
冠状动脉疾病 /
超声心动描记术
Key words
Ventricular function, left /
Coronary disease /
Echocardiography
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基金
辽宁省自然科学基金（20170540381）。
