论文部分内容阅读
目的应用斑点追踪成像技术(speckle tracking imaging,STI)评价冠心病患者行冠脉内支架置入术(percuta-neous coronary intervention,PCI)或冠脉搭桥术(coronary artery by pass grafting,CABG)前后不同阶段左心室的局部和整体收缩功能。方法选取新桥医院心内科2010年11月至2011年10月期间行PCI术治疗的冠心病患者35例(男性21例,女性14例),年龄(56.1±12.5)岁,选取本院心外科同期行CABG手术治疗的冠心病患者30例(男性19例,女性11例),年龄(57.8±14.8)岁,分别于手术前3 d、术后1、3、6个月时行超声心动图检查,采集相应时间点的左心室二维图像;另选年龄性别相匹配的48名健康者作为正常对照组;比较分析其常规超声心动图参数、二维应变参数的变化差异,以及各组在各时间点内的相关性。结果①冠心病PCI组及CABG组术前常规心脏超声参数(E/A、LVEF)STI,参数(GBLS、GBRS、GBCS、Prot apex、Prot base、Ptw)均显著低于正常对照组(P<0.05)。②冠心病PCI组术后1、3、6个月各阶段的参数值均较术前增高且呈递增趋势,但仍低于正常对照组(P<0.05);术后各阶段参数值与术前比较差异显著(P<0.05)。③冠心病CABG组术后3、6个月STI参数与正常组比较,差异有统计学意义(P<0.05),但术后1个月测值较术前比较无明显改善(P>0.05)。④PCI及CABG组的GBLS、GBRS、GBCS均与LVEF显著性相关(P<0.01)。结论 STI可以定量评价冠心病患者行PCI或CABG手术治疗前后左室局部及整体收缩功能,对评价治疗效果及预后具有重要的临床价值。
Objective To evaluate the effect of speckle tracking imaging (STI) before and after percuta-neous coronary intervention (PCI) or coronary artery bypass grafting (CABG) Stage Left ventricular local and global systolic function. Methods Thirty-five patients (21 males and 14 females) with coronary heart disease who underwent PCI from November 2010 to October 2011 were enrolled in this study. Their age was (56.1 ± 12.5) years. Thirty patients (19 males and 11 females) with coronary artery disease undergoing CABG surgery at the same period (57.8 ± 14.8 years old) underwent echocardiography at 3 days before surgery and at 1, 3, and 6 months after surgery. The left ventricular two-dimensional images at the corresponding time points were collected and examined. Forty-eight healthy subjects of the same age and gender were selected as the normal control group. The changes of the conventional echocardiographic parameters and two-dimensional strain parameters were compared and analyzed. Relevance in each time point. Results ① The preoperative echocardiographic parameters (E / A, LVEF) STI and parameters (GBLS, GBRS, GBCS, Prot apex, Protbase, Ptw) in PCI group and CABG group were significantly lower than those in the normal control group 0.05). ② The parameters in each stage of PCI at 1, 3, and 6 months after PCI in CHD group were higher than those before PCI, but still lower than those in control group (P <0.05) Before the difference was significant (P <0.05). ③ The STI parameters at 3 and 6 months after CABG in CHD group were significantly different from those in normal group (P <0.05), but the measured values at 1 month after operation were not significantly improved (P> 0.05) . The GBLS, GBRS and GBCS in PCI and CABG groups were significantly correlated with LVEF (P <0.01). Conclusion STI can quantitatively evaluate the local and global left ventricular systolic and diastolic function before and after PCI or CABG in patients with coronary heart disease. It has important clinical value in evaluating the therapeutic effect and prognosis.