冠心病患者左心室室壁平均位移与左前降支狭窄率关系研究

Relationship between average displacement of left ventricular wall and the stenosis rate of left anterior descending in patients with coronary heart disease

目的应用实时三维超声心动图（real-time three-dimensional echocardiography,RT-3DE）评价左前降支（left anterior descending,LAD）不同程度狭窄冠心病患者左心室室壁平均位移,探讨左心室室壁平均位移与LAD狭窄的关系。方法冠心病患者133例依据LAD狭窄程度分为4组,狭窄〈25%组35例,狭窄25%~50%组28例,狭窄〉50%~75%组30例,狭窄〉75%组40例,行RT-3DE检查后应用QLAB软件测量4组左心室室壁平均位移,分析平均位移与狭窄率的相关性。结果狭窄〈25%组和狭窄25%~50%组牛眼图上颜色分布均匀,狭窄〉50%~75%组和狭窄〉75%组颜色分布不均,甚至出现红色;狭窄〈25%组左心室室壁平均位移为（6.67±1.41）mm,狭窄25%~50%组为（6.50±1.39）mm,狭窄〉50%~75%组为（4.61±0.57）mm,狭窄〉75%组为（2.36±0.65）mm,除狭窄〈25%组和狭窄25%~50%组比较差异无统计学意义（P〉0.05）外,其他各组间比较差异均有统计学意义（P〈0.05）;LAD狭窄〉50%时LAD支配区平均位移与狭窄程度呈负相关（r=-0.89,P=0.001）。结论应用RT-3DE技术测量左心室室壁平均位移可用于估测冠心病患者LAD的狭窄程度。

Objective To evaluate the average displacement of left ventricular wall in patients with coronary heart disease by real-time three-dimensional echocardiography（RT-3DE）to analyze the relationship between the average displacement of left ventricular wall and the stenosis of left anterior descending（LAD）.Methods According to different stenosis degrees of LAD,the patients with coronary heart disease were divided into four groups,stenosis25% group（n=35）,stenosis 25%to 50% group（n=28）,stenosis50%to 75% group（n=30）and stenosis75% group（n=40）.The average displacements of left ventricular wall were calculated by QLAB after examined by RT-3DE in four groups to analyze the relationship between average displacement and stenosis rate.Results The bull eye showed well-distributed color in LAD stenosis25% and 25% to 75% groups,and mal-distributed even red color in LAD stenosis 〉50% to75% and 〉75% groups.The average displacement of left ventricular chamber wall was（6.67±1.41）mm in stenosis25% group,（6.50±1.39）mm in stenosis 〈25%to 50% group,（4.61±0.57）mm in stenosis50%to 75% group,and（2.36±0.65）mm in stenosis 75% group.There were significant differences among all groups（P〉0.05）except between 〈25% group and 25%to 50% group（P〈0.05）.The average displacement of the left ventricular regional wall was negatively correlated with the degree of arterial stenosis when the LAD stenosis was 〉50%（r=-0.89,P=0.001）.Conclusion The average displacement of left ventricular wall measured by RT-3DE technique can estimate LAD stenosis degree in patients with coronary heart disease.