实时三维超声及二维斑点追踪技术对拟诊冠心病患者局部室壁运动的评价.pdf

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1、天津医药2014年12月第42卷第l2期1229实时三维超声及二维斑点追踪技术对拟诊冠心病患者局部室壁运动的评价田园王伟周长钰【摘要】目的探讨实时三维超声(RT一3DE)及二维斑点追踪成像(2D—STI)技术检测拟诊冠心病患者局部室壁运动功能的临床应用价值。方法选取临床拟诊为冠心病、二维超声示室壁运动正常的住院患者143例，根据冠脉造影左冠状动脉主干(LM)和(或)左前降支(LAD)和(或)左回旋支(LCX)病变结果分为狭窄t>75％组(A组)73例和狭窄<75％组(B组)70例。应用RT一3DE及2D—ST1分别检测并比较2组患者左室节段射血分数(sEF)和收缩期纵向峰值应变(s)，利用RO

2、C曲线此较2种技术诊断冠心病的曲线下面积。结果(1)A组病变冠脉所支配室壁的sEF及s均较B组减小(P<0．05)；(2)节段平均sEF与节段平均s呈正相关(r=0．689，P<0．05)；(3)两项指标均显示异常的左冠供血各节段sEF对诊断供血冠脉狭窄I>75％的曲线下面积大于s(最大曲线下面积分别为0．922和0．874)。结论RT一3DE及2D—STI均可评估冠心病患者的心肌局部运动状况，进而推测冠脉病变程度，但RT一3DE指标可能更优于2D—STI。【关键词】冠心病；实时三维超声；二维斑点追踪技术；局部室壁运动【中图分类号】R445．1，R541．4【文献标志码】A【DOI】10．39

3、69／j．issn．0253—9896．2014．12．022EvaluationofRegionalWalIMotioninPatientswithSuspectedCoronaryArteryDiseasebyReal—TimeThree—DimensionalEchocardiographyandTwO—DimensionalSpeckleTrackingImagingTIANYuan，WANGWei，ZHOUChangyuDepartmentofCardiology,theSecondHospitalofTianjinMedicalUniversity,Tianjin300211，Ch

4、inaCorrespondingAuthorE—mail：zhouchangyu@126．com【Abstract】ObjectiveToevaluatetheclinicalvalueoftheregionalwallmotioninpatientswithsuspectedcoronaryarterydiseasebyreal～timethree—dimensionaleehocardiography(RT一3DE)andtwo—dimensionalspeckletrackingimaging(2D—STI)．MethodsAtotalof143hospitaizedpatientswi

5、thsuspectedcoronarya~erydiseaseandnormalwallmotionde—tectedbytwo—dimensionalechocardiography(2DE)wereenrolledanddevidedintogroupA(coronarystenosis／>75％)73casesandgroupB(coronarystenosis<75％)thatinclude70casesaccordingtocoronaryangiographyresults．Leftventficu-larsegmentalejectionfraction(sEF)wasmeasu

6、redbyRT一3DEandpeaksystoliclongitudialstrain(SL)wasmeasuredby2D—STI．ROCCHIVESofthetwomeasurementsweregeneratedandcompared．DifferencesinsEFandSLbetweengroupAandgroupBwererespectivelyanalyzed．Results(1)BothsEFofRT一3DEandSLof2D—STIingroupAweresignificantlylow—erthanthoseingroupB(尸

7、elycorrelatedwithSL(r=0．689，P<0．05)；(3)ComparedwithSL，sEFhadlargerareaunderROCchIVeinsomesegmentsofleftventriclewherebothparametersareabnormalforthediagnosisofthecoronarystenosis>／75％f0．922vs0．874)．Co