二维斑点追踪技术评价冠心病患者PCI术后左室心肌运动功能改变的价值

Two-dimensional spot tracking technology(STI) to evaluate the changes of the function of myocardium of left ventricle of Coronary heart disease after PCI

目的:探讨二维斑点追踪技术(STI)及室壁运动积分法(WMS)评价冠心病患者PCI术后心肌节段收缩功能改变的价值。方法:选取冠心病行PCI术40例(冠心病组),健康人40例(健康对照组)。对健康对照组及冠心病组于术前及术后1周行超声心动图检查,计算室壁运动积分,应用STI获得左室6个壁基底段、中间段、心尖段的收缩期纵向峰值应变值(SLs)、整体纵向峰值应变(GSL)、舒张早期纵向峰值应变率(Sr Le)。结果:冠心病组患者术前左室心肌室壁运动指数较正常对照组明显升高(P<0.05),冠心病组患者术后左室心肌室壁运动指数较术前明显减低(P<0.05)。与健康对照组比较,冠心病组术前心肌缺血节段SLs、Sr Le及GSL减低(均P<0.05);冠心病组术后1周相应节段的SLs、Sr Le及GSL均较术前显著提高(均P<0.05)。结论:二维斑点追踪技术及室壁运动积分法均可评价冠脉狭窄导致心肌局部和整体功能的异常和即刻PCI手术治疗的效果,冠心病患者左室运动功能减退,PCI术后绝大部分缺血心肌节段的局部收缩、舒张功能都得到了显著改善。

Objective Using STI and WMSI to evaluate the change of the heart sarcomere local systolic function which suffered from coronaH~ heart disease （CHD）, to evaluate the improvement of ischemic heart sarcomere local systolic function after PCI. Methods There are 40 CHD patients after PCI called the treatment group and 40 healthy persons called the control group. Echocardiogram was used to evaluate the change of ventricular wall motion score in the treatment group which was before and 1 week after PCI, compared with the control group. STI is used to get the SLs, GSL and SrLe of the left ventricle six walls in basal segment,middle segmentand apical segment systole. Results The ventricular wall motion index of the left ventricular myocardium obviously rose in CHD patients which was after PCI, compared with the control group （P 〈 0.05）. And it obviously reduced in CHD patients after PCI, compared with CHD patients before PCI（P 〈 0.05）. The results of SLs,GSL and SrLe are reduced in myocardial ischemia segment of CHD patients before PCI,compared with the control group （P 〈 0.05）. But they are significantly improved in the the treatment group 1 week after PCI, compared to which is before PCI（P 〈 0.05）. Conclusion STI and WMS can be used to evaluate the abnormal of regional and global function of myocardium which is caused to coronary artery stenosis the effect of PCI. The left ventricular motion function of CHD is decreased, but the left ventricle regional systolic function of hypokinetic segments in patients with CHD after PCI is significantly increased.