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目的探讨左室扭转、左心室壁力学与容积间关系在评价冠心病患者左心室收缩同步性方面的临床应用价值。方法 26例心肌梗死患者、24例心肌缺血患者和30例正常对照者分别行二维斑点追踪(2D-STI)、实时三维超声心动图(RT-3DE)检查。2D-STI获得左心室16、12节段收缩期纵向、径向、环向应变及旋转角度标化达峰时间(Tls-16%、Trs-12%、Tcs-12%、Trot-12%)及心底与心尖部收缩期旋转角度标化达峰时间(Tbase%、Tapex%)等左心室壁力学时间指标。RT-3DE获得左心室容积时间指标(Tmsv-16%),计算两者时间差(Tlsv%、Trsv%、Tcsv%、Trotv%)及心底与心尖部收缩期旋转达峰时间差(Tabrot%)。结果缺血组Tls-16%、Tmsv-16%、Tlsv%较对照组延长,差异有统计学意义(P<0.05);心肌梗死组上述时间指标均较缺血组和对照组延长,差异均有统计学意义(P<0.05)。结论左心室扭转、左心室壁力学与容积间的关系均可评价心肌梗死患者左心室收缩不同步性。Tlsv%可早期检测心肌缺血患者左心室收缩不同步性。
Objective To investigate the clinical value of the relationship between left ventricular torsion, left ventricular wall mechanics and volume in the assessment of left ventricular systolic synchrony in patients with coronary heart disease. Methods Two-dimensional speckle tracking (2D-STI) and real-time three-dimensional echocardiography (RT-3DE) were performed in 26 patients with myocardial infarction, 24 patients with myocardial ischemia and 30 normal controls. (Tls-16%, Trs-12%, Tcs-12%, Trot-12%) of 2D, And cardiac and apical systolic rotation angle of the peak time (Tbase%, Tapex%) and other left ventricular wall mechanical time index. The time of left ventricular volume (Tmsv-16%) was obtained by RT-3DE, and the time difference between Tlsv%, Trsv%, Tcsv%, Trotv% and Tabrot% was calculated. Results The percentage of Tls-16%, Tmsv-16% and Tlsv% in ischemic group was longer than that in control group (P <0.05). The time of myocardial infarction group was longer than that of ischemic group and control group There was statistical significance (P <0.05). Conclusion The relationship between left ventricular torsion, left ventricular wall mechanics and volume can be used to evaluate the left ventricular systolic asynchrony in patients with myocardial infarction. Tlsv% early detection of myocardial ischemia in patients with left ventricular systolic asynchrony.