应变率成像评价冠心病患者支架置入术后局部心肌功能的临床价值

Clinical value of strain rate imaging in evaluating regional myocardial function after stent implantation in patients with coronary heart disease

目的探讨应变率成像(SRI)技术评价冠心病患者冠状动脉支架置入术后局部心肌功能的临床价值。方法应用应变率成像技术测定28例冠心病患者冠状动脉支架置入术前、术后(20±5)d及20例正常人左室壁各节段收缩期、收缩期后及舒张早期的纵向峰值应变率SRS、SRPSS、SRE,计算收缩期后收缩波(PSS)发生率及SRPSS/SRS比值。结果与正常对照组相比,冠心病组缺血节段的SRS和SRE显著降低(P<0.01),PSS发生率,SRPSS和SRPSS/SRS显著增高(P<0.05)。冠心病组缺血节段支架置入术前、术后PSS发生率,SRPSS、SRS和SRE的改变均无统计学意义(P>0.05),而SRPSS/SRS术后较术前显著减低(P<0.01)。结论SRPSS/SRS比SRS、SRE、SRPSS更能敏感地评价支架置入术后局部心肌功能改善状况。

Objective To explore clinical value of strain rate imaging（SRI） in evaluating regional myocardial function after stent implantation in patients with coronary heart disease （CHD）. Methods Twenty eight patients with CHD before and after stent implantation and twenty normal control subjects were enrolled in the study. Longitudinal peak strain rate of left ventricular walls during systole （SRs）, postsystolic shortening （SRPss） and rapid filling （ SRE ） were measured, as well as the incidence of PSS and ratio of SRPss/SRs. Results Compared with normal segments of control, SRs and SRE of isehemic segments of CHD reduced significantly （ P 〈 0.01 ）, the incidence of PSS, SRPSS and SRPss/SRs increased significantly （ P 〈 0.05）. Between before and after stent implantation, the incidence of PSS, SRPss, SRs and SRE have no statistical differences （ P 〉 0.05）, while SRPss/SRs of after operation obviously decreased than that of before operation （ P 〈 0.01 ）. Conclusion Compare with SRs ,SRE. SRPss, SRPss/SRs can more sensitively evaluate the functional improvement of regional myocardium after stent implantation.