TDI和Tei指数对比分析冠心病支架治疗前、后左室功能

Comparative Analysis of Left Ventricular Function of Coronary Heart Disease in Anterior and Posterior of Plus Stent Implantation Therapy by Using TDI and the Tei Index

目的应用组织多普勒成像(TDI)技术检测二尖瓣环运动,脉冲多普勒血流检测Tei指数,Teichholtz法计算心功能,探讨三种检测方法准确评价冠心病支架治疗前、后左室功能的时机和优劣。方法 18例行支架植入治疗的冠心病(CHD)患者;20例年龄55-70岁健康人作为对照。CHD组又分为支架植入术前、术后5天、15天、30天、3个月进行检测,应用TDI检测二尖瓣前、后叶(AMV,PMV)瓣环运动速度,脉冲多普勒检测二尖瓣及主动脉瓣口血流频谱以计算Tei指数,用Teichholtz法计算EF、FS、SV、SI、CO、CI。结果 CHD组支架植入术前EF、FS显著下降,Tei指数则显著升高,二尖瓣环运动速度减低。术后5天,Tei指数显著降低,其余指标改变不明显。术后15天,EF、FS和舒张功能指标也显著改善。术后1个月,大部分监测指标和术后3个月所有监测指标均接近或恢复至对照组水平。结论评价左心功能的各种检测方法均有其优点和局限性,故在评价冠心病支架手术疗效时,应尽可能选用多种方法、多项指标,以作出综合评估。

Objective To comparative evaluate the left ventricular function in the patients with the coronary Heart disease in anterior and posterior of the PTCA plus stent implantation therapy,we use the Tissue Doppler Imaging（TDI） technique to detect the mitral valve movement,pulsed wave to calculate Tei index and Teichholtz formula to compute left ventricular function,by contrasting their advantages and disadvantages when evaluating the left ventricular function.Methods The comparative group including 20 health adults aged 55-70 years and the CHD group incluing 18 patients with CHD and received PTCA puls stent implantation therapy in this study.Detection were performed between the comparative group and the CHD group before and 5 days,15 days 1 month,and 3 monthes after PTCA puls stent implantation in two-dimensional echocardiography,M-type echocardiography,pulsed Doppler to calculate the Tei index and TDI-mode to observe the mitral valve movement with 6 pots as posterior intervalseptum,lateral wall,anterior intervalseptum,posterior wall,interior wall and anterior wall.At the same time,to calculate EF,FS,SV,SI,CO,CI using the Teichholtz formura.Results EF and FS broke down notably before stent implantation in the CHD group patientsthe.velocity of the annulus of MR movement reduced,while Tei index advanced notably.Only Tei index siginificantly cut down in 5 days after implantation.15 days later,EF、FS and diastolic function index notably improved.1 month after therapy,most of the monitoring targets and all the monitoring targets 3 monthes after operation approached to or returned back to the health group.Conclusions All the detect parameters by sorts of means above had their ments and localizations,so we should adopt more indicatrixes as possiblely to get the synthesis evaluation when we wanted to evaluate the curative effect in PTCA plus stent implantation therapy.