目的：探讨二维斑点追踪显像技术评价急性心力衰竭患者经冻干重组人脑利钠肽（新活素，rhBNP）治疗后左心室心肌扭转力学参数之变化。方法：40例急性心力衰竭患者均给予常规治疗的基础上应用新活素，分别于新活素治疗前及治疗后应用STI技术检测左心室心尖旋转角度峰值、心底旋转角度峰值、左心室扭转角度峰值、解旋速度峰值、扭转角度达峰时间，同时设40名健康志愿者为对照组。结果：与对照组比较，急性心力衰竭患者新活素治疗前左心室心尖旋转角度峰值、心底旋转角度峰值、左心室扭转角度峰值、解旋速度峰值均明显下降（P均<0.001），扭转角度达峰时间提前（P<0.001）。其中，心尖旋转角度峰值（Par）下降较心底旋转角度峰值（Pbr）相对明显。rhBNP治疗后患者各扭转参数均有一定程度改善，各参数与对照组比较差异仍有统计学意义（P均<0.05）。结论：rhBNP治疗能有效改善急性心力衰竭患者左心功能，二维斑点追踪显像技术可定量、客观的评价左心室心肌力学变化，此为rhBNP疗效评定和急性心力衰竭患者预后判定提供了一种无创手段。
Abstract
Objective: To investigate the left ventricular twist in patients with acute heart failure after treatment by rhBNP using two-dimensional speckle tracking imaging． Methods: Forty cases of acute heart failure patients were given conventional therapy. Respectively, in the application of the rhBNP before and after treatment, the left ventricular mechanics parameters were obtainted, the parameters included peak apical rotation(Par), peak basal rotation(Pbr), peak twist(Ptw）, peak untwist velocity(PutwV), time to peak twist（TPK). The above data of another 40 healthy volunteers were measured as control. Results: Compared with control group, Par, Pbr, Ptw and PutwV of patients with acute heart failure all obviously decreased before treatment by rhBNP(all P<0.001) among them, Par relatively obvious decline compared Pbr, the twist parameters improved in some degrees after treatment by rhBNP, but were still lower compared to those of control group(all P<0.05). Conclusion: rhBNP treatment can effectively improve the left ventricular function in patients with acute heart failure, 2D-STI can assess left ventricular myocardiac mechanics changes after rhBNP treatment quantitatively and objectively, and provide an effective and noninvasive method for clinical evaluation of left ventricular function．
关键词
心力衰竭 /
充血性；心室功能 /
左；超声心动描记术
Key words
Heart failure, congestive /
Ventricular function, left /
Echocardiography
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