二维斑点追踪技术对急性心肌梗死行经皮冠状动脉介入治疗患者左室运动功能的评价

Assessment of Left Ventricular Myocardial Function in Patients With Acute Myocardial Infarction Before and After PCI by 2D- STI

目的探讨二维斑点追踪技术(STI)评价急性广泛前壁心肌梗死行经皮冠状动脉介入治疗(PCI)前、后左室心肌运动功能的临床应用价值。方法选择2012年12月—2013年12月佳木斯大学附属第一医院心内科行PCI的急性广泛前壁心肌梗死患者25例为病例组,选择同期30例健康医务人员及患者家属作为对照组。对照组与病例组PCI前及PCI后1、4、12周时行二维超声检查,对比分析两组各心肌节段收缩期纵向应变(LS)、径向应变(RS)、圆周应变(CS)的变化及差异。结果病例组应变-时间曲线杂乱,对照组应变-时间曲线分布均一。病例组PCI后1周LS、RS、CS峰值与术前比较,差异无统计学意义(P>0.05);病例组PCI后4、12周LS、RS、CS峰值均较术前、PCI后1周升高,病例组PCI后12周LS、RS、CS峰值均较PCI后4周升高,差异有统计学意义(P<0.05)。结论二维STI可以定量评价急性广泛前壁心肌梗死患者行PCI前、后左室心肌的运动功能,可作为评价PCI疗效的参考指标。

Objective To investigate the clinical application value of 2-dimensional speckle tracking imaging（2D-STI）in the assessment of left ventricular myocardial function in patients with acute extensive anterior myocardial infarction before and after percutaneous coronary intervention（ PCI）. Methods We enrolled 25 patients with acute extensive anterior myocardial infarction who received PCI therapy in the Department of Cardiology in the First Affiliated Hospital of Jiamusi University from December 2012 to December 2013 as the case group. And 30 health workers and relatives of patients were enrolled as the control group. Two-dimensional ultrasonography testing was conducted on the control group and the case group before PCI and 1 week, 4 weeks and 12 weeks after PCI. The two groups were compared by the changes and differences of longitudinal strain（ LS）, radial strain （ RS ） and circumferential strain （ CS ） during the systolic period in different segments of myocardial muscle. Results The strain-time curves of the case group were in disorder,while those of the control group were averagely distributed. For the case group,the peak values of LS,RS and CS were no difference（P〉0. 05）between week 1 and before PCI. For the case group,the peak values of LS,RS and CS at week 4 and week 12 after surgery were higher（P〈0. 05）than those before PCI and at week 1;the peak values of LS,RS and CS at week 12 after PCI were higher（P〈0. 05）than those at week 4 after PCI. Conclusion The 2D-STI can be used to assess myocardial function of left ventricular in patients with acute extensive anterior myocardial infarction before and after PCI and can also be taken as the reference index for the assessment of the efficacy of PCI.