论文部分内容阅读
目的：本试验主要观察急性心肌梗死(AMI)患者患病24小时内心肌各节段收缩相应力峰值(ε)和应变率峰值(SR)在不同血管直径的AMI非梗死相关血管(NIRA)供血节段的变化,并与正常人相应节段对比,探讨ε和SR在NIRA供血节段是否存在功能代偿；是否可以敏感发现危险区域。方法：以31例首次发病的AMI患者为研究对象,其中急性前壁心肌梗死(MI)14例,IRA为前降支(LAD)；急性下壁M117例,IRA为回旋支(LCX)10例,IRA为右冠状动脉(RCA)7例；所有病人均在发病24小时内获取其标准心尖二腔、长轴、四腔彩色组织多普勒图象,描记心肌各节段的应变成像(Strain)和应变率成像(SPI)曲线,测量基底段和中段部收缩相相关峰值。40例正常人作为对照同样测量相关数据。结果：NIRA狭窄程度＞50％时,AMI患者的SR与正常人相比,除前壁及前间隔中段外所有节段均有不同程度减低(P＜0.001、P＜0.01或P＜0.05),而AMI患者ε与正常人相比只有在NtRA狭窄程度＞70％时(前间隔中段除外)才有不同程度减低(P＜0.001、P＜0.01或P＜0.05),令人疑惑的是NIRA狭窄程度＜50％时出现反常的结果,ε及SA在大多数节段均有不同程度减低(P＜0.001、P＜0.01或P＜0.05),未发现代偿性功能增强。结论：Strain、SRI能够敏感、准确、定量、无创的评估NIRA＞50％以上狭窄的缺血心肌,为临床提供了可床旁测量、方便快捷的诊疗手段。
Objective: To observe the relationship between peak systolic strain (ε) and peak strain rate (SR) at different segments of the AMI non-infarct-related blood vessel (NIRA) in patients with acute myocardial infarction (AMI) Section changes, and compared with normal corresponding segments to explore whether ε and SR in the NIRA blood supply section whether there is functional compensation; whether the sensitive area can be found. Methods: A total of 31 AMI patients with AMI were included in this study. Among them, 14 cases were acute anterior myocardial infarction (MI) and IRA were anterior descending (LAD); acute inferior wall M117 cases and IRA 10 cases of LCX , And 7 cases of right coronary artery (RCA) with IRA. All patients received their standard apical 2-cavity, long-axis and 4-cavity color Doppler images within 24 hours after onset. Strain imaging ) And strain rate imaging (SPI) curves were measured for the peak correlations between the contractile phase in the basal and mid-segments. 40 normal people as a control also measure the relevant data. Results: Compared with the normal subjects, the SR of AMI patients were significantly reduced (P <0.001, P <0.01 or P <0.05) in all segments except the anterior wall and middle segment of anterior septum with NIRA stenosis> 50% In contrast, in patients with AMI, ε was reduced to varying degrees (P <0.001, P <0.01, or P <0.05) with NtRA stenosis> 70% (except in the middle of the anterior segment) compared with normal controls. What is puzzling is that NIRA stenosis Abnormal results were observed when the degree was less than 50%, while ε and SA were decreased in most of the segments (P <0.001, P <0.01 or P <0.05). No compensatory enhancement was found. Conclusion: Strain and SRI can sensitively, accurately, quantitatively and noninvasively assess ischemic myocardium with> 50% NIRA. It provides a convenient method for bedside measurement and convenient diagnosis and treatment.