二维超声斑点追踪显像技术在心血管危险分层中的应用价值

Value of two dimensional ultrasound spot tracking imaging techniques in cardiovascular risk stratification

目的:探讨二维超声斑点追踪技术应用于心血管危险分层的价值和准确性。方法:选择本院收治的86例冠心病患者,依据心血管事件风险大小分为低危组、中危组和高危组,另选择24例健康人作为对照组;采用二维超声斑点追踪技术检测4组患者的颈动脉整体圆周应变(CS),并测定患者的颈动脉内中膜厚度(IMT),采用多元线性回归分析评估Framingham危险评分(FRS)与CS、CS/肱动脉脉压差(PP)、IMT间的相关性。结果:CS、CS/PP、IMT在冠心病患者与对照组之间差异均有统计学意义(P<0.05);中危组、高危组CS、IMT、CS/PP与低危组间差异均有统计学意义(P<0.05);CS与FRS间呈负相关(P>0.05,r=-0.910),IMT与FRS间呈正相关(P>0.05,r=0.939),CS/PP与FRS间呈线性相关(P<0.05)。结论:采用二维超声斑点追踪技术测定患者的颈动脉整体CS能够反映患者心血管事件风险的大小,采用PP进行校正后更能够提高准确率,值得推广。

Objective： To discuss value and accuracy of two dimensional ultrasound spot tracking imaging techniques in cardiovascular risk stratification. Methods： 86 cases of patients with coronary heart disease in our hospital were selected, according to the risk size of cardiovascular events, the patients were divided into low risk group, medium risk group and high risk group, other 24 healthy persons were selected as control group; carotid artery global circumferential strain （CS） of patients in the four groups were measured using two- dimensional ultrasound spot tracking techniques, carotid intima-media thickness （MIT） was also detected. The correlation between FRS and CS, CS/PP were analyzed and evaluated by the multivariate linear regression. Results： CS, CS/ PP, IMT were significantly different between patients with coronary heart disease and the control group （P 〈 0. 05） ）. There were significant differences in CS, IMT and CS/PP among medium risk group and high risk group and low risk group（P 〈0. 05）. There was a negative correlation between CS and FRS（P 〉0. 05 ,r = -0. 910） ,and a positive correlation between IMT and FRS （ P 〉 0. 05, r = 0. 939 ）, still a linear correlation between CS/PP and FRS（ P 〈 0. 05 ）. Conclusion： Two-dimensional ultrasound speckle tracking technique detecting carotid artery global circumferential strain can reflect cardiovascular risk size; it is more accurate when pulse pressure is corrected, thus, it is worthy of promotion.